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2550 Windy Hill Rd Se Ste 115 Marietta GA 30067-8607 | |
| (678) 580-2684 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2550 Windy Hill Rd Se Ste 115, Marietta, Georgia |
| Authorized Official Name and Position | Randall Lee Haupt (EXECUTIVE VICE PRESIDENT, SGI) |
| Authorized Official Contact | 4702923820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2550 Windy Hill Rd Se Ste 115 Marietta GA 30067-8607 Ph: (678) 580-2684 | 2550 Windy Hill Rd Se Ste 115 Marietta GA 30067-8607 Ph: (678) 580-2684 |
| NPI Number | 1487378071 |
|---|---|
| Provider Enumeration Date | 09/28/2022 |
| Last Update Date | 10/29/2024 |
| Medicare PECOS PAC ID | 6305202268 |
|---|---|
| Medicare Enrollment ID | O20230518001702 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487378071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Frank David Curvin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457397382 PECOS PAC ID: 1557321353 Enrollment ID: I20041015000638 |
| Provider Name | Julia M Choe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942692942 PECOS PAC ID: 9436478203 Enrollment ID: I20150428001802 |
| Provider Name | Satoya Dubose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306214820 PECOS PAC ID: 8022312438 Enrollment ID: I20180727002666 |
| Provider Name | Bereshith Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497026066 PECOS PAC ID: 4284892597 Enrollment ID: I20220421001765 |
| Provider Name | Suniko Hickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912629593 PECOS PAC ID: 4486020807 Enrollment ID: I20221026000664 |
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