Peachtree Primary Care PC
Family Medicine in Roswell, GA. Organization (NPI-2).
NPI number1437428331
StatusActive
Last updated in NPPESMay 4, 2012
Details
- NPI
- 1437428331
- Entity type
- Organization (NPI-2)
- Legal business name
- Peachtree Primary Care PC
- Organization subpart
- No
- Enumeration date
- Dec 21, 2011
- Last updated
- May 4, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 065787 | GA | Yes |
Practice location
1570 Old Alabama RdRoswell, GA 30076-2107
Phone 770-676-6838 · Fax 770-676-6840
Mailing address
1570 Old Alabama RdSuite 105
Roswell, GA 30076-2107
Phone 770-676-6838 · Fax 770-676-6840
Authorized official
Anila H Qidwai
Owner
7706766838
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