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NPI Code Detail

MEDICARE: SUGARLOAF MEDICAL P.C.

MEDICARE: SUGARLOAF MEDICAL P.C.
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
1207R00000XInternal Medicine Physician057537GA

General Provider Information

NPI Number : 1255483111
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUGARLOAF MEDICAL P.C.
Provider Business Mailing Address
First Line : 1300 PEACHTREE INDUSTRIAL BLVD
Second Line : UNIT 4203
City : SUWANEE
State : GA
Zip : 30024-4539
Country : US
Telephone Number : 770-831-3018
Fax Number : 770-831-3669
Provider Business Practice Location Address
First Line : 1300 PEACHTREE INDUSTRIAL BLVD
Second Line : UNIT 4203
City : SUWANEE
State : GA
Zip : 30024-4539
Country : US
Telephone Number : 770-831-3018
Fax Number : 770-831-3669
Authorized Official
Title or Position : DOCTOR, CEO
Name : DR. SHUKRI GEORGE MAKHLOUF
Credential : M.D.
Telephone Number : 770-713-8663
Provider Enumeration Date : 01/18/2007
Last Update Date : 10/02/2015

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Directions to “SUGARLOAF MEDICAL P.C. ” Practice Location

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