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General NPI Number Information
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NPI Number | 1023265873
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Entity Type | Organization
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Legal Business Name | ACCURATE MEDICAL DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 08/23/2008
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Last Update Date | 08/23/2008
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Provider Practice Location Address
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Address Line | 1498 DULWICH CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7535
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Country | US
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Telephone | 404-641-6552
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Fax | 800-419-1589
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Provider Business Mailing Address
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Address Line | 1498 DULWICH CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-7535
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Country | US
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Telephone | 404-641-6552
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Fax | 800-419-1589
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Authorized Official
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Title or Position | OWNER
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Name | MR. DANIEL DOMINQUEZ
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Credential |
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Telephone | 404-447-5735
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 025580
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License Number State | GA
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