Healthcare Provider Details

I. General information

NPI: 1619131299
Provider Name (Legal Business Name): JOHN J. PAIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 NORTHSIDE FORSYTH DR STE 450
CUMMING GA
30041-8483
US

IV. Provider business mailing address

PO BOX 117598
ATLANTA GA
30368-7598
US

V. Phone/Fax

Practice location:
  • Phone: 678-947-6440
  • Fax: 678-513-4764
Mailing address:
  • Phone: 770-442-1911
  • Fax: 770-442-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number61310
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: