MEDICARE: JOHN N MURIMI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	58373	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	111887	OTHER	GA	UGS-REIDSVILLE
2	111830	OTHER	GA	UGS-SWAINSBORO
3	111889	OTHER	GA	UGS-SOPERTON

General Provider Information

NPI Number	:	1245319516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN N MURIMI MD

Provider Business Mailing Address
First Line	:	4550 COBB PARKWAY NW
Second Line	:	SUITE 201
City	:	ACWORTH
State	:	GA
Zip	:	30101-4001
Country	:	US
Telephone Number	:	770-974-4655
Fax Number	:	770-974-1970

Provider Business Practice Location Address
First Line	:	4900 IVEY RD NW
Second Line	:	SUITE 1301
City	:	ACWORTH
State	:	GA
Zip	:	30101-4001
Country	:	US
Telephone Number	:	770-974-4655
Fax Number	:	770-974-1970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	09/19/2012

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Directions to “ JOHN N MURIMI MD” Practice Location

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