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General NPI Number Information
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NPI Number | 1427130301
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Entity Type | Organization
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Legal Business Name | ROSWELL INTERNAL MEDICINE SPECIALISTS PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 11785 NORTHFALL LN SUITE 505
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City | ALPHARETTA
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State | GA
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Zip | 30009-7971
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Country | US
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Telephone | 678-393-0012
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Fax | 678-393-5158
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Provider Business Mailing Address
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Address Line | 4050 ROCKINGHAM DR
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City | ROSWELL
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State | GA
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Zip | 30075-6459
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Country | US
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Telephone | 770-645-8295
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GORKA ZURINAGA
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Credential | MD
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Telephone | 678-393-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 040290
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License Number State | GA
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