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METAMORPHOSIS MEDICAL GROUP NPI 1538458690


NPI Information

NPI: 1538458690
Provider Name: METAMORPHOSIS MEDICAL GROUP
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1792 WOODSTOCK RD
BLDG 300
ROSWELL, GA
ZIP 30075
Phone: (678) 218-1710
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METAMORPHOSIS MEDICAL GROUP is a medical specialty clinic center in Roswell, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). METAMORPHOSIS MEDICAL GROUP NPI is 1538458690. The provider is registered as an organization entity type.

The provider's business location address is:

1792 WOODSTOCK RD
BLDG 300
ROSWELL, GA
ZIP 30075-199
Phone: (678) 218-1710
Fax: (678) 218-1714

The provider's authorized official is Deborah Lyn Levich .
The authorized official title is Ceo and has the following contact phone number (678) 218-1710.

The enumeration date for this NPI number is 3/29/2011 and was last updated on 3/29/2011.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical Specialty044520GEORGIAYes

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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