Constellation Emergency Physicians, LLC
Emergency Medicine in Snellville, GA. Organization (NPI-2).
NPI number1124485412
StatusActive
Last updated in NPPESJan 19, 2016
Details
- NPI
- 1124485412
- Entity type
- Organization (NPI-2)
- Legal business name
- Constellation Emergency Physicians, LLC
- Organization subpart
- No
- Enumeration date
- Jan 19, 2016
- Last updated
- Jan 19, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | – | – | Yes |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
1700 Medical WaySnellville, GA 30078-2195
Phone 469-401-2386
Mailing address
Po Box 80043Philadelphia, PA 19101-1043
Authorized official
Gregory J. Byrne
Officer
4694012386
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