My Online Doctor'S Visit LLC
Family Medicine in Douglasville, GA. Organization (NPI-2).
NPI number1205410032
StatusActive
Last updated in NPPESMay 7, 2021
Details
- NPI
- 1205410032
- Entity type
- Organization (NPI-2)
- Legal business name
- My Online Doctor'S Visit LLC
- Organization subpart
- No
- Enumeration date
- May 7, 2021
- Certification date
- May 7, 2021
- Last updated
- May 7, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207P00000X | Emergency Medicine | – | – | |
| 208000000X | Pediatrics | – | – | |
| 207R00000X | Internal Medicine | – | – |
Other names
- Myodv (Doing Business As)
Practice location
5651 Tuxedo DrDouglasville, GA 30135-7526
Phone 678-444-8780
Mailing address
1870 The Exchange Se Ste 200-44Atlanta, GA 30339-2036
Phone 866-448-8319
Authorized official
Dingane Baruti
Ceo
8664488319
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