Healthcare Provider Details

I. General information

NPI: 1578742870
Provider Name (Legal Business Name): SCHILLING HEALTHCARE ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2007
Last Update Date: 05/18/2022
Certification Date: 05/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 EAGLES LANDING PKWY STE 300
STOCKBRIDGE GA
30281-9250
US

IV. Provider business mailing address

290 COUNTRY CLUB DR SUITE 130
STOCKBRIDGE GA
30281-9069
US

V. Phone/Fax

Practice location:
  • Phone: 770-474-7151
  • Fax:
Mailing address:
  • Phone: 770-474-7151
  • Fax: 770-506-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NGAN PHAM
Title or Position: PRESIDENT
Credential: MD
Phone: 770-474-7151