| Northside Nama Professional Services, Llc | |
|
2545 Lawrenceville Hwy Ste 200 Decatur GA 30033-3240 | |
| (770) 934-7876 | |
| Not Available |
| Full Name | Northside Nama Professional Services, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2545 Lawrenceville Hwy Ste 200, Decatur, Georgia |
| Authorized Official Name and Position | Jorge Hernandez (CCO) |
| Authorized Official Contact | 4048516378 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northside Nama Professional Services, Llc 1000 Johnson Ferry Road, Ne Attn: Jorge Hernandez Atlanta GA 30342 Ph: (404) 851-6379 | Northside Nama Professional Services, Llc 2545 Lawrenceville Hwy Ste 200 Decatur GA 30033-3240 Ph: (770) 934-7876 |
| NPI Number | 1205481736 |
|---|---|
| Provider Enumeration Date | 08/01/2019 |
| Last Update Date | 08/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205481736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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