Healthcare Provider Details

I. General information

NPI: 1457239741
Provider Name (Legal Business Name): UNITY INTEGRATED HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 W CANDLER ST
WINDER GA
30680-2558
US

IV. Provider business mailing address

1306 CALGARY LAKE DR
WINDER GA
30680-4916
US

V. Phone/Fax

Practice location:
  • Phone: 404-640-7367
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code225XL0004X
TaxonomyLow Vision Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DARNELLE AMBO
Title or Position: OWNER
Credential:
Phone: 404-640-7367