Healthcare Provider Details

I. General information

NPI: 1811434210
Provider Name (Legal Business Name): SWIFT HEALTH MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 04/20/2022
Certification Date: 04/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6053 JONESBORO RD
MORROW GA
30260-1106
US

IV. Provider business mailing address

5185 OLD NATIONAL HWY STE 200
COLLEGE PARK GA
30349-3244
US

V. Phone/Fax

Practice location:
  • Phone: 770-824-4343
  • Fax:
Mailing address:
  • Phone: 404-763-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number66254
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FELIX I AMOA-BONSU
Title or Position: PHYSICIAN
Credential: MD
Phone: 770-824-4343