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General NPI Number Information
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NPI Number | 1366159873
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Entity Type | Organization
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Legal Business Name | MIM URGENT CARE & FAMILY PRACTICE INC
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 5380 PEACHTREE INDUSTRIAL BLVD STE 150
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City | NORCROSS
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State | GA
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Zip | 30071-1565
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Country | US
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Telephone | 678-515-8154
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Fax |
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Provider Business Mailing Address
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Address Line | 5380 PEACHTREE INDUSTRIAL BLVD STE 150
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City | NORCROSS
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State | GA
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Zip | 30071-1565
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Country | US
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Telephone | 678-515-8154
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HANNAH AKOSUAH QUARSHIE
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Credential | FNP-C
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Telephone | 678-515-8154
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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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