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General NPI Number Information
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NPI Number | 1396188876
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Entity Type | Organization
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Legal Business Name | EAST METRO PRIMARY CARE
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Dates
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Enumeration Date | 04/15/2013
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Last Update Date | 04/15/2013
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Provider Practice Location Address
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Address Line | 325 LESTER RD NW SUITE C
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-4024
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Country | US
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Telephone | 770-935-1515
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Fax | 770-935-1040
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Provider Business Mailing Address
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Address Line | 325 LESTER RD NW SUITE C
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-4024
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Country | US
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Telephone | 770-935-1515
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Fax | 770-935-1040
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Authorized Official
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Title or Position | PROVIDER
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Name | DR. AFROZ RAHMAN
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Credential | MD
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Telephone | 770-935-1515
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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 | 017940
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License Number State | GA
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