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General NPI Number Information
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NPI Number | 1447856653
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Entity Type | Organization
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Legal Business Name | CHARIS HEALTHCARE LLC
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 2365 POWDER SPRINGS RD SW STE 1103
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City | MARIETTA
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State | GA
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Zip | 30064-4574
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Country | US
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Telephone | 470-604-9800
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Fax | 470-604-9900
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Provider Business Mailing Address
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Address Line | 3936 HEMINGWAY DR
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-5094
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | IBIJOKE SOLANKE
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Credential | NP
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Telephone | 470-604-9800
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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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