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990 Peachtree Industrial Blvd Number 4532 Suwanee GA 30024-5249 | |
(678) 475-1400 | |
Not Available |
Full Name | |
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Speciality | Family Medicine - Geriatric Medicine |
Location | 990 Peachtree Industrial Blvd Number 4532, Suwanee, Georgia |
Authorized Official Name and Position | Kirpich Joseph (PRESIDENT) |
Authorized Official Contact | 6784751400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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990 Peachtree Industrial Blvd Unit 4532 Suwanee GA 30024-5249 Ph: (678) 475-1400 | 990 Peachtree Industrial Blvd Number 4532 Suwanee GA 30024-5249 Ph: (678) 475-1400 |
NPI Number | 1457604381 |
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Provider Enumeration Date | 10/16/2012 |
Last Update Date | 10/16/2012 |
Identifier | Type | State | Issuer |
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1457604381 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207QG0300X | Family Medicine - Geriatric Medicine | 054904 (Georgia) | Primary |
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