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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PROVIDENCE MEDICAL GROUP, PC

Active Organization

PROVIDENCE MEDICAL GROUP, PC is a Internal Medicine organization located in ATLANTA, Georgia. NPI 1063570604 is currently active in the NPPES registry. Verify at CMS.

Internal Medicine · ATLANTA, GA

Registration Details

NPI Number
1063570604
Provider Type
Organization
NPI Issued
Dec 5, 2006 (19.719611564601 yrs)
Last Updated
Jun 19, 2012
License
051703 (GA)

Practice Information

Address
550 PEACHTREE ST NE
SUITE 1285
ATLANTA, GA, 303082249
Browse GA providers · Browse ZIP 30308
Phone
4048563213
Fax
4048563217
Primary Specialty
Internal Medicine
207R00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.