ADVANCED INTERNAL MEDICINE NPI 1669658829

NPI Information

NPI: 1669658829
Provider Name: ADVANCED INTERNAL MEDICINE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
235 MEDICAL BLVD
SUITE B
STOCKBRIDGE, GA
ZIP 30281
Phone: (770) 960-8855
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ADVANCED INTERNAL MEDICINE is a primary care clinic center in Stockbridge, GA. ADVANCED INTERNAL MEDICINE NPI is 1669658829. The provider is registered as an organization entity type.

The provider's business location address is:

235 MEDICAL BLVD
SUITE B
STOCKBRIDGE, GA
ZIP 30281-218
Phone: (770) 960-8855
Fax: (678) 565-1140

The provider's authorized official is Faosat O Odemuyiwa .
The authorized official title is Manager and has the following contact phone number (770) 960-8855.

The enumeration date for this NPI number is 1/17/2008 and was last updated on 6/30/2010.

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
1	261QP2300X	Clinic/Center	Primary Care	07-12143	GEORGIA	Yes

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

NPI Synchronization or Removal

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