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MY DOCTORS CLINIC LLC NPI 1497183941


NPI Information

NPI: 1497183941
Provider Name: MY DOCTORS CLINIC LLC

Doing Business As: PEACH CLINIC

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 11D2080808

Address:
2320 ATLANTA HWY
SUITE - 105
CUMMING, GA
ZIP 30040
Phone: (678) 473-0715
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MY DOCTORS CLINIC LLC is a family medicine in Cumming, GA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MY DOCTORS CLINIC LLC NPI is 1497183941. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Peach Clinic.

The provider's business location address is:

2320 ATLANTA HWY
SUITE - 105
CUMMING, GA
ZIP 30040-339
Phone: (678) 473-0715

The provider's authorized official is Ketan Ghia .
The authorized official title is Manager and has the following contact phone number (678) 473-0715.

The CLIA number assigned to this NPI record is 11D2080808 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2013 and was last updated on 1/16/2014.


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
1173000000XLegal Medicine052826GEORGIANo
22080P0214XPediatricsPediatric Pulmonology63536GEORGIANo
3207R00000XInternal Medicine052826GEORGIANo
4207RS0012XInternal MedicineSleep Medicine052826GEORGIANo
5207Q00000XFamily Medicine61431GEORGIAYes

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

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