Healthcare Provider Details

I. General information

NPI: 1003528860
Provider Name (Legal Business Name): AVC MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2022
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 LINCOLN PKWY E STE 315
ATLANTA GA
30346-2209
US

IV. Provider business mailing address

1455 LINCOLN PKWY E STE 315
ATLANTA GA
30346-2209
US

V. Phone/Fax

Practice location:
  • Phone: 404-777-1728
  • Fax: 404-777-1729
Mailing address:
  • Phone: 404-777-1728
  • Fax: 833-471-4352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHAD ALEMAN
Title or Position: OWNER
Credential: MD
Phone: 404-777-1728