| Mount Vernon Premier Care, Llc | |
|
755 Mount Vernon Hwy Ne Suite 400 Atlanta GA 30328-4274 | |
| (404) 419-9970 | |
| (404) 252-8930 |
| Full Name | Mount Vernon Premier Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 755 Mount Vernon Hwy Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Gladstone Arnold Sellers (PARTNER) |
| Authorized Official Contact | 4044199970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mount Vernon Premier Care, Llc 755 Mount Vernon Hwy Ne Suite 400 Atlanta GA 30328-4274 Ph: (404) 419-9970 | Mount Vernon Premier Care, Llc 755 Mount Vernon Hwy Ne Suite 400 Atlanta GA 30328-4274 Ph: (404) 419-9970 |
| NPI Number | 1427337021 |
|---|---|
| Provider Enumeration Date | 08/12/2011 |
| Last Update Date | 08/12/2011 |
| Medicare PECOS PAC ID | 5294902318 |
|---|---|
| Medicare Enrollment ID | O20120112000596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427337021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 35513 (Georgia) | Primary |
| Provider Name | David Mclean Dubose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912087800 PECOS PAC ID: 8820283914 Enrollment ID: I20101115001081 |
| Provider Name | Gladstone Arnold Sellers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063521102 PECOS PAC ID: 8820286412 Enrollment ID: I20101227000098 |
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