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General NPI Number Information
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NPI Number | 1114585049
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Entity Type | Organization
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Legal Business Name | STAT INTERNAL MEDICINE, LLC
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Dates
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Enumeration Date | 06/05/2019
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 6065 ROSWELL RD STE 450
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City | ATLANTA
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State | GA
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Zip | 30328-4011
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Country | US
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Telephone | 770-728-8028
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Fax |
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Provider Business Mailing Address
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Address Line | 6065 ROSWELL RD STE 450
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City | ATLANTA
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State | GA
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Zip | 30328-4011
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | NICHOLA PATTON
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Credential | NP
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Telephone | 770-728-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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