| Mdvip Medical Group Ga-atl | |
|
1800 Howell Mill Rd Nw Ste 525 Atlanta GA 30318-2538 | |
| (404) 537-8081 | |
| (404) 367-3085 |
| Full Name | Mdvip Medical Group Ga-atl |
|---|---|
| Speciality | Internal Medicine |
| Location | 1800 Howell Mill Rd Nw Ste 525, Atlanta, Georgia |
| Authorized Official Name and Position | Andrea Klemes (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 5619824300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mdvip Medical Group Ga-atl 1800 Howell Mill Rd Nw Ste 525 Atlanta GA 30318-3188 Ph: (404) 537-8081 | Mdvip Medical Group Ga-atl 1800 Howell Mill Rd Nw Ste 525 Atlanta GA 30318-2538 Ph: (404) 537-8081 |
| NPI Number | 1154859817 |
|---|---|
| Provider Enumeration Date | 05/25/2017 |
| Last Update Date | 03/21/2023 |
| Medicare PECOS PAC ID | 5597021386 |
|---|---|
| Medicare Enrollment ID | O20171110001968 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154859817 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Andrey Popykin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952373615 PECOS PAC ID: 6002854627 Enrollment ID: I20050425001054 |
| Provider Name | Crystal A Young-wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588743165 PECOS PAC ID: 3375621279 Enrollment ID: I20080417000261 |
| Provider Name | Reginald S Fowler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144391715 PECOS PAC ID: 5294815304 Enrollment ID: I20080604000319 |
| Provider Name | Carol Aitcheson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104919083 PECOS PAC ID: 8224113725 Enrollment ID: I20080618000266 |
| Provider Name | Wyman P Sloan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639264922 PECOS PAC ID: 2668532938 Enrollment ID: I20081117000149 |
| Provider Name | Meenakshi Kakarala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033100797 PECOS PAC ID: 9032263637 Enrollment ID: I20090817000450 |
| Provider Name | Adrian C Douglass |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245393396 PECOS PAC ID: 0941336291 Enrollment ID: I20100326000070 |
| Provider Name | Brooks S Lide,iii |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083777056 PECOS PAC ID: 4183752470 Enrollment ID: I20100506000642 |
| Provider Name | Sheppard Dunlevie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932293719 PECOS PAC ID: 2365568458 Enrollment ID: I20100927000404 |
| Provider Name | Karl Dannehl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356401954 PECOS PAC ID: 4183740111 Enrollment ID: I20100928000826 |
| Provider Name | Kirti Chavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417259243 PECOS PAC ID: 7517100233 Enrollment ID: I20130828000789 |
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