| Milton Medical Group, Llc | |
|
735 N Main St 1100 Alpharetta GA 30009-2405 | |
| (678) 827-9157 | |
| (470) 299-6262 |
| Full Name | Milton Medical Group, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 735 N Main St, Alpharetta, Georgia |
| Authorized Official Name and Position | Savitha Shama (OWNER) |
| Authorized Official Contact | 6788279157 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Milton Medical Group, Llc 11585 Jones Bridge Rd 420-215 Johns Creek GA 30022-8129 Ph: (678) 827-9157 | Milton Medical Group, Llc 735 N Main St 1100 Alpharetta GA 30009-2405 Ph: (678) 827-9157 |
| NPI Number | 1043680341 |
|---|---|
| Provider Enumeration Date | 09/29/2015 |
| Last Update Date | 07/19/2016 |
| Medicare PECOS PAC ID | 5092019604 |
|---|---|
| Medicare Enrollment ID | O20160202001068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043680341 | NPI | - | NPPES |
| 003173272A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 046324 (Georgia) | Primary |
| Provider Name | Savitha Shama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447205240 PECOS PAC ID: 8527193614 Enrollment ID: I20100315000475 |
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