=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285818351
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOTAL MEDICAL CARE PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2007
-----------------------------------------------------
Last Update Date | 07/29/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1300 PEACHTREE INDUSTRIAL BLVD SUITE 4105
-----------------------------------------------------
City | SUWANEE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30024-4539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-482-5550
-----------------------------------------------------
Fax | 678-765-6012
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1300 PEACHTREE INDUSTRIAL BLVD SUITE 4105
-----------------------------------------------------
City | SUWANEE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30024-4539
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-482-5550
-----------------------------------------------------
Fax | 678-765-6012
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | REKHA SINGH
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 678-482-5550
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------