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General NPI Number Information
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NPI Number | 1003550856
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Entity Type | Organization
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Legal Business Name | FIRST CHOICE DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 303 PERIMETER CTR N STE 300
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City | DUNWOODY
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State | GA
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Zip | 30346-3401
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Country | US
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Telephone | 612-232-2947
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 GLENRIDGE STRATFORD DR
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City | ATLANTA
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State | GA
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Zip | 30342-4945
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Country | US
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Telephone | 612-232-2947
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHELSEA EGWIM
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Credential |
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Telephone | 612-232-2947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number |
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License Number State |
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