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General NPI Number Information
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NPI Number | 1184787210
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Entity Type | Organization
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Legal Business Name | PEACHTREE INTERNAL MEDICINE, P.C.
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 35 COLLIER RD NW SUITE 500
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City | ATLANTA
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State | GA
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Zip | 30309-1613
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Country | US
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Telephone | 404-350-1010
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Fax | 404-355-7338
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Provider Business Mailing Address
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Address Line | 35 COLLIER RD NW SUITE 500
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City | ATLANTA
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State | GA
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Zip | 30309-1613
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Country | US
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Telephone | 404-350-1010
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Fax | 404-355-7338
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | MRS. PAT SARGENT
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Credential |
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Telephone | 404-350-1010
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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 |
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License Number State | GA
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