Healthcare Provider Details

I. General information

NPI: 1891247896
Provider Name (Legal Business Name): GWINNETT CONVENIENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2016
Last Update Date: 03/18/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 SCENIC HWY N STE 266
SNELLVILLE GA
30078-7924
US

IV. Provider business mailing address

2148 DULUTH HWY SUITE 112
DULUTH GA
30097-4506
US

V. Phone/Fax

Practice location:
  • Phone: 470-436-8248
  • Fax: 470-729-7562
Mailing address:
  • Phone: 770-820-1826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SYED S H ZAIDI
Title or Position: OWNER
Credential: MD
Phone: 404-242-5666