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General NPI Number Information
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NPI Number | 1124508973
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Entity Type | Organization
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Legal Business Name | PREMIER INTERNAL MEDICINE OF ALPHARETTA, PC
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Dates
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Enumeration Date | 08/20/2018
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Last Update Date | 11/18/2018
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Provider Practice Location Address
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Address Line | 3665 OLD MILTON PKWY STE 30
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City | ALPHARETTA
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State | GA
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Zip | 30005-2406
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Country | US
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Telephone | 919-264-0720
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Fax |
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Provider Business Mailing Address
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Address Line | 7778 MCGINNIS FERRY RD # 266
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City | SUWANEE
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State | GA
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Zip | 30024-1622
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Country | US
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Telephone | 678-369-6993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIRA P. COLBERT
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Credential | MD
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Telephone | 678-369-6993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 79075
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License Number State | GA
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