| Neighbormd Of South Atlanta Llc | |
|
3885 Princeton Lakes Way Sw Ste 412 Atlanta GA 30331-5599 | |
| (404) 344-6000 | |
| (404) 344-6575 |
| Full Name | Neighbormd Of South Atlanta Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, Georgia |
| Authorized Official Name and Position | David Romanello (COO) |
| Authorized Official Contact | 3524593661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighbormd Of South Atlanta Llc 3885 Princeton Lakes Way Sw Ste 412 Atlanta GA 30331-5599 Ph: (404) 344-6000 | Neighbormd Of South Atlanta Llc 3885 Princeton Lakes Way Sw Ste 412 Atlanta GA 30331-5599 Ph: (404) 344-6000 |
| NPI Number | 1285235036 |
|---|---|
| Provider Enumeration Date | 11/06/2020 |
| Last Update Date | 08/19/2021 |
| Medicare PECOS PAC ID | 1850794736 |
|---|---|
| Medicare Enrollment ID | O20210729002693 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285235036 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Nakato Bonni Kibuyaga-travis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609031657 PECOS PAC ID: 5092982520 Enrollment ID: I20120124000229 |
| Provider Name | Joel T Isom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194930222 PECOS PAC ID: 3375788300 Enrollment ID: I20130322000369 |
| Provider Name | Natasha Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386033132 PECOS PAC ID: 1951689975 Enrollment ID: I20161026001660 |
| Provider Name | Audrey Caryn Roberson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811495385 PECOS PAC ID: 9335549609 Enrollment ID: I20210609000563 |
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