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THE SOUTHEAST PERMANENTE MEDICAL GROUP NPI 1245266956


NPI Information

NPI: 1245266956
Provider Name: THE SOUTHEAST PERMANENTE MEDICAL GROUP
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
3495 PIEDMONT ROAD NE
NINE PIEDMONT CENTER
ATLANTA, GA
ZIP 30305
Phone: (404) 364-3821
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THE SOUTHEAST PERMANENTE MEDICAL GROUP is an internal medicine in Atlanta, 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. THE SOUTHEAST PERMANENTE MEDICAL GROUP NPI is 1245266956. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3495 PIEDMONT ROAD NE
NINE PIEDMONT CENTER
ATLANTA, GA
ZIP 30305-773
Phone: (404) 364-3821

The provider's authorized official is Michael Doherty .
The authorized official title is Associate Medical Director and has the following contact phone number (404) 364-2245.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 7/18/2017.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyNo
2207Q00000XFamily MedicineNo
3207V00000XObstetrics & GynecologyNo
4207Y00000XOtolaryngologyNo
5208000000XPediatricsNo
62084P0800XPsychiatry & NeurologyPsychiatryNo
72085R0202XRadiologyDiagnostic RadiologyNo
8208600000XSurgeryNo
9208800000XUrologyNo
10208M00000XHospitalistNo
11213E00000XPodiatristNo
12363A00000XPhysician AssistantNo
13363L00000XNurse PractitionerNo
14367A00000XAdvanced Practice MidwifeNo
15207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP948MEDICARE ID-TYPE UNSPECIFIEDGROUP MEDICARE NUMBER

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.