| Pro-med Of Atlanta, Pc | |
|
4646 North Shallowford Road #400 Atlanta GA 30338 | |
| (770) 676-6000 | |
| (770) 392-9805 |
| Full Name | Pro-med Of Atlanta, Pc |
|---|---|
| Speciality | General Practice |
| Location | 4646 North Shallowford Road, Atlanta, Georgia |
| Authorized Official Name and Position | Susan Tanner (MEDICAL DOCTOR) |
| Authorized Official Contact | 7706766000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pro-med Of Atlanta, Pc 4646 N Shallowford Rd #400 Atlanta GA 30338-6308 Ph: (770) 676-6000 | Pro-med Of Atlanta, Pc 4646 North Shallowford Road #400 Atlanta GA 30338 Ph: (770) 676-6000 |
| NPI Number | 1730491473 |
|---|---|
| Provider Enumeration Date | 07/10/2010 |
| Last Update Date | 07/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730491473 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | AT2218116 (Georgia) | Primary |
| 208D00000X | General Practice | (* (Not Available)) | Secondary |
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