| Metro Medical Associates Llc | |
|
11379 Southbridge Pkwy Suite A Alpharetta GA 30022-4469 | |
| (770) 777-0750 | |
| (770) 777-0521 |
| Full Name | Metro Medical Associates Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 11379 Southbridge Pkwy, Alpharetta, Georgia |
| Authorized Official Name and Position | Pavan Mamilla (OWNER) |
| Authorized Official Contact | 7707770750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metro Medical Associates Llc 11379 Southbridge Pkwy Suite A Alpharetta GA 30022-4469 Ph: (770) 777-0750 | Metro Medical Associates Llc 11379 Southbridge Pkwy Suite A Alpharetta GA 30022-4469 Ph: (770) 777-0750 |
| NPI Number | 1982619789 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 01/02/2024 |
| Medicare PECOS PAC ID | 2567568603 |
|---|---|
| Medicare Enrollment ID | O20070507000020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982619789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 054164 (Georgia) | Primary |
| Provider Name | Pavan K Mamilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417188103 PECOS PAC ID: 6103072962 Enrollment ID: I20180523002377 |
| Provider Name | Swetha Addagatla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376925503 PECOS PAC ID: 7012215312 Enrollment ID: I20190916001088 |
| Provider Name | Jenson T Mathew |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285291070 PECOS PAC ID: 0244565174 Enrollment ID: I20220718001857 |
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