Healthcare Provider Details

I. General information

NPI: 1679303226
Provider Name (Legal Business Name): GCMD MEDICAL CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 WYNGATE PKWY STE 210
WOODSTOCK GA
30189-6983
US

IV. Provider business mailing address

2045 PEACHTREE RD NE STE 310
ATLANTA GA
30309-1407
US

V. Phone/Fax

Practice location:
  • Phone: 678-384-7305
  • Fax: 770-928-9109
Mailing address:
  • Phone: 404-222-9914
  • Fax: 770-504-4105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAOLA PAZ
Title or Position: ADMINISTRATION SUPPORT
Credential:
Phone: 305-316-3380