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General NPI Number Information
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NPI Number | 1154443414
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Entity Type | Organization
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Legal Business Name | SUBURBAN MEDICAL CENTER
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 4989 PEACHTREE PKWY STE 100
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-2589
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Country | US
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Telephone | 770-582-1300
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Fax | 770-582-1317
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Provider Business Mailing Address
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Address Line | 4989 PEACHTREE PKWY STE 100
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-2589
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Country | US
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Telephone | 770-582-1300
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Fax | 770-582-1317
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Authorized Official
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Title or Position | OWNER
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Name | DR. SUNIT SINGHAL
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Credential | M.D.
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Telephone | 770-582-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | GA 58812
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 035763
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License Number State | GA
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