| Mercy Internal Medicine Associated Pc | |
|
8225 Mall Pkwy Ste 240 Lithonia GA 30038-6995 | |
| (770) 484-3092 | |
| (770) 484-3096 |
| Full Name | Mercy Internal Medicine Associated Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8225 Mall Pkwy Ste 240, Lithonia, Georgia |
| Authorized Official Name and Position | Olufunso A Ojo (PHYSICIAN) |
| Authorized Official Contact | 7704843095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Internal Medicine Associated Pc 8225 Mall Pkwy Ste 240 Lithonia GA 30038-6995 Ph: (770) 484-3092 | Mercy Internal Medicine Associated Pc 8225 Mall Pkwy Ste 240 Lithonia GA 30038-6995 Ph: (770) 484-3092 |
| NPI Number | 1710038856 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 12/17/2012 |
| Medicare PECOS PAC ID | 8325052335 |
|---|---|
| Medicare Enrollment ID | O20060130000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710038856 | NPI | - | NPPES |
| 1316991748 | Other | GA | NPI FOR DR OJO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 054004 (* (Not Available)) | Primary |
| Provider Name | Olufonso A Ojo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316991748 PECOS PAC ID: 1850368846 Enrollment ID: I20040910000150 |
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