| Otis Prestige | |
|
109 Anderson St Se Ste 200a Marietta GA 30060-8610 | |
| (470) 301-8528 | |
| Not Available |
| Full Name | Otis Prestige |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 109 Anderson St Se Ste 200a, Marietta, Georgia |
| Authorized Official Name and Position | Damian Drago (ADMINISTRATOR) |
| Authorized Official Contact | 4703018528 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Otis Prestige 55 Atlanta St Se Ste 101 Marietta GA 30060-1977 Ph: (470) 301-8528 | Otis Prestige 109 Anderson St Se Ste 200a Marietta GA 30060-8610 Ph: (470) 301-8528 |
| NPI Number | 1992431753 |
|---|---|
| Provider Enumeration Date | 07/25/2022 |
| Last Update Date | 07/25/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992431753 | NPI | - | NPPES |
| 4703018528 | Other | GA | 4703018528 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
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