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General NPI Number Information
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NPI Number | 1316115025
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE CONSULTANTS, P.C.
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 206 E BROAD ST
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City | WINDER
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State | GA
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Zip | 30680
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Country | US
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Telephone | 770-867-3208
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Fax | 770-867-3218
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Provider Business Mailing Address
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Address Line | PO BOX B
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City | WINDER
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State | GA
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Zip | 30680-0137
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Country | US
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Telephone | 770-867-3208
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Fax | 770-867-3218
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CHARLES N EKINDE
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Credential | MD
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Telephone | 770-867-3208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 059633
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License Number State | GA
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