Healthcare Provider Details

I. General information

NPI: 1629699160
Provider Name (Legal Business Name): INTEGRITY BUSINESS MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2020
Last Update Date: 10/28/2020
Certification Date: 10/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3796 SATELLITE BLVD STE 201
DULUTH GA
30096-5698
US

IV. Provider business mailing address

3796 SATELLITE BLVD STE 201
DULUTH GA
30096-5698
US

V. Phone/Fax

Practice location:
  • Phone: 800-559-4707
  • Fax:
Mailing address:
  • Phone: 800-559-4707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL CHUKELU
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 800-559-4704