GWINNETT MEDICAL GROUP INC NPI 1780747469

NPI Information

NPI: 1780747469
Provider Name: GWINNETT MEDICAL GROUP, INC

Former Legal Business Name: GWINNETT MEDICAL SERVICES, INC

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA
ZIP 30046
Phone: (678) 312-5525
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GWINNETT MEDICAL GROUP, INC is a general practice in Lawrenceville, GA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee GWINNETT MEDICAL GROUP, INC NPI is 1780747469. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Gwinnett Medical Services, Inc.

The provider's business location address is:

1000 MEDICAL CENTER BLVD
LAWRENCEVILLE, GA
ZIP 30046-694
Phone: (678) 312-5525
Fax: (770) 339-2120

The provider's authorized official is Steven A Rubin .
The authorized official title is Executive Director and has the following contact phone number (470) 325-0150.

The enumeration date for this NPI number is 12/18/2006 and was last updated on 2/2/2015.

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	License State	Primary
1	207Q00000X	Family Medicine	GEORGIA	No
2	207R00000X	Internal Medicine	GEORGIA	No
3	207T00000X	Neurological Surgery	GEORGIA	No
4	208600000X	Surgery	GEORGIA	No
5	208000000X	Pediatrics	GEORGIA	No
6	208D00000X	General Practice	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	202G703128	MEDICARE PIN	GEORGIA

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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