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General NPI Number Information
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NPI Number | 1255603684
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Entity Type | Organization
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Legal Business Name | FAST CARE CLINIC CORPORATION
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Dates
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Enumeration Date | 02/01/2012
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 3795 BUFORD DR
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City | BUFORD
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State | GA
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Zip | 30519-4906
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Country | US
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Telephone | 866-935-6066
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Fax | 866-935-6066
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Provider Business Mailing Address
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Address Line | PO BOX 1179
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City | SUWANEE
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State | GA
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Zip | 30024-0966
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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 | GENERAL SECRETARY
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Name | MR. SANJAY NARIANI
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Credential | M.D.
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Telephone | 770-374-1789
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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 |
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License Number State |
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