Organization · NPI-2

Hillandale Internal Medicine, PC

Internal Medicine · Lithonia, GA

NPI number1861781320
StatusActive
Last updated in NPPESApr 5, 2011

Details

NPI
1861781320
Entity type
Organization (NPI-2)
Legal business name
Hillandale Internal Medicine, PC
Organization subpart
No
Enumeration date
Apr 5, 2011
Last updated
Apr 5, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine041109GAYes

Practice location

5900 Hillandale Dr
Annex E
Lithonia, GA 30058-3802

Phone 770-987-8400 · Fax 770-987-8494

Mailing address

5900 Hillandale Dr
Annex E
Lithonia, GA 30058-3802

Phone 770-987-8400 · Fax 770-987-8494

Authorized official

Wallace Duncan
Ceo
7709878400

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