Northside Primary Care, Inc. | |
11800 Northfall Ln Suite 1401 Alpharetta GA 30009-7976 | |
(678) 867-0904 | |
(678) 867-0905 |
Full Name | Northside Primary Care, Inc. |
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Speciality | Internal Medicine |
Location | 11800 Northfall Ln, Alpharetta, Georgia |
Authorized Official Name and Position | Aazrum I Syed (PRESIDENT) |
Authorized Official Contact | 6788670904 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northside Primary Care, Inc. 11800 Northfall Ln Suite 1401 Alpharetta GA 30009-7976 Ph: (678) 867-0904 | Northside Primary Care, Inc. 11800 Northfall Ln Suite 1401 Alpharetta GA 30009-7976 Ph: (678) 867-0904 |
NPI Number | 1548584972 |
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Provider Enumeration Date | 03/14/2010 |
Last Update Date | 02/01/2011 |
Medicare PECOS PAC ID | 6204023609 |
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Medicare Enrollment ID | O20110920000911 |
Identifier | Type | State | Issuer |
---|---|---|---|
1548584972 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 61759 (Georgia) | Primary |
Provider Name | Aazrum I Syed |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1598938706 PECOS PAC ID: 7214068352 Enrollment ID: I20100915000167 |
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