Proactive Physicians Of Marietta, Pc | |
790 Church St Ne Suite 220 Marietta GA 30060-7282 | |
(678) 753-9300 | |
(678) 753-9300 |
Full Name | Proactive Physicians Of Marietta, Pc |
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Speciality | Clinic/Center |
Location | 790 Church St Ne, Marietta, Georgia |
Authorized Official Name and Position | Richard Scott Mills (COO) |
Authorized Official Contact | 6787942216 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Proactive Physicians Of Marietta, Pc 790 Church St Ne Suite 220 Marietta GA 30060-7282 Ph: (678) 753-9300 | Proactive Physicians Of Marietta, Pc 790 Church St Ne Suite 220 Marietta GA 30060-7282 Ph: (678) 753-9300 |
NPI Number | 1003356361 |
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Provider Enumeration Date | 03/06/2017 |
Last Update Date | 03/06/2017 |
Medicare PECOS PAC ID | 2961773791 |
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Medicare Enrollment ID | O20170811002382 |
Identifier | Type | State | Issuer |
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1003356361 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Richard L Griffith |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1528050838 PECOS PAC ID: 1759350671 Enrollment ID: I20041001000681 |
Provider Name | Richard S Mills |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407848716 PECOS PAC ID: 8022087949 Enrollment ID: I20041004000414 |
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