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NPI 1245319516

NPI 1245319516 : JOHN N MURIMI MD : ACWORTH, GA

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General NPI Number Information
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    NPI Number           |    1245319516
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN N MURIMI MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/06/2006
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    Last Update Date     |    09/19/2012
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Provider Practice Location Address
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    Address Line         |    4900 IVEY RD NW SUITE 1301
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    City                 |    ACWORTH
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    State                |    GA
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    Zip                  |    30101-4001
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    Country              |    US
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    Telephone            |    770-974-4655
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    Fax                  |    770-974-1970
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Provider Business Mailing Address
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    Address Line         |    4550 COBB PARKWAY NW SUITE 201
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    City                 |    ACWORTH
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    State                |    GA
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    Zip                  |    30101-4001
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    Country              |    US
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    Telephone            |    770-974-4655
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    Fax                  |    770-974-1970
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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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       |    58373
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    License Number State |    GA
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