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ST. MARY'S MEDICAL GROUP INC. NPI 1174914873


NPI Information

NPI: 1174914873
Provider Name: ST. MARY'S MEDICAL GROUP, INC.

Other Name: COMMUNITY INTERNAL MEDICINE OF ATHENS

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 11D2109835

Address:
1500 OGLETHORPE AVE STE 200C
ATHENS, GA
ZIP 30606
Phone: (706) 389-3875
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ST. MARY'S MEDICAL GROUP, INC. is an internal medicine in Athens, GA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. ST. MARY'S MEDICAL GROUP, INC. NPI is 1174914873. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Community Internal Medicine Of Athens.

The provider's business location address is:

1500 OGLETHORPE AVE STE 200C
ATHENS, GA
ZIP 30606-165
Phone: (706) 389-3875
Fax: (706) 389-3876

The provider's authorized official is D. Montez Carter .
The authorized official title is President & Ceo and has the following contact phone number (706) 389-3930.

The CLIA number assigned to this NPI record is 11D2109835 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/17/2015 and was last updated on 3/12/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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