Healthcare Provider Details

I. General information

NPI: 1669899449
Provider Name (Legal Business Name): CARE FAMILY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 04/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 FLAT SHOALS RD SUITE 250
DECATUR GA
30034-1637
US

IV. Provider business mailing address

3660 FLAT SHOALS RD SUITE 250
DECATUR GA
30034-1637
US

V. Phone/Fax

Practice location:
  • Phone: 404-664-4549
  • Fax:
Mailing address:
  • Phone: 404-458-4842
  • Fax: 404-458-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN HOLMES
Title or Position: OWNER
Credential:
Phone: 404-664-4549