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General NPI Number Information
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NPI Number | 1053638205
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Entity Type | Organization
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Legal Business Name | MOUNTAIN TOP PRIMARY CARE MEDICAL ASSOCIATES
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Dates
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Enumeration Date | 04/28/2010
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Last Update Date | 04/28/2010
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Provider Practice Location Address
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Address Line | 200 INDUSTRIAL BLVD SUITE 114
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City | ELLIJAY
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State | GA
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Zip | 30540-3722
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Country | US
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Telephone | 706-636-4364
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Fax | 706-636-5264
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Provider Business Mailing Address
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Address Line | 200 INDUSTRIAL BLVD SUITE 114
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City | ELLIJAY
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State | GA
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Zip | 30540-3722
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Country | US
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Telephone | 706-636-4364
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Fax | 706-636-5264
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MUHAMMAD MATEEN AKMAL
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Credential | M.D.
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Telephone | 706-636-4364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 044665
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License Number State | GA
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