WATERFORD MEDICAL CLINIC NPI 1366712846

NPI Information

WATERFORD MEDICAL CLINIC is a general practice in Atlanta, GA. WATERFORD MEDICAL CLINIC NPI is 1366712846. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3069 AMWILER RD
SUITE TWO
ATLANTA, GA
ZIP 30360-825
Phone: (678) 969-9920
Fax: (678) 969-9919

The provider's authorized official is John Salinas .
The authorized official title is Medical Director and has the following contact phone number (404) 992-9130.

The enumeration date for this NPI number is 12/30/2011 and was last updated on 12/30/2011.

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:

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