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ST. MARY'S MEDICAL GROUP INC. NPI 1336446608


NPI Information

NPI: 1336446608
Provider Name: ST. MARY'S MEDICAL GROUP, INC.

Doing Business As: NORTHEAST CARDIOLOGY

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

CLIA Number: 11D2023143

Address:
700 SUNSET DR STE 302
ATHENS, GA
ZIP 30606
Phone: (706) 548-9111
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ST. MARY'S MEDICAL GROUP, INC. is a cardiovascular disease internal medicine in Athens, GA. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. ST. MARY'S MEDICAL GROUP, INC. NPI is 1336446608. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Northeast Cardiology.

The provider's business location address is:

700 SUNSET DR STE 302
ATHENS, GA
ZIP 30606-721
Phone: (706) 548-9111
Fax: (706) 548-9224

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 11D2023143 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/22/2011 and was last updated on 3/30/2018.


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
1207RC0000XInternal MedicineCardiovascular DiseaseYes

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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