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General NPI Number Information
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NPI Number | 1477723526
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Entity Type | Organization
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Legal Business Name | ISHWAR FAMILY MEDICINE LLC
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 02/04/2015
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Provider Practice Location Address
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Address Line | 6045 SOUTHARD TRACE
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City | CUMMING
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State | GA
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Zip | 30040
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Country | US
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Telephone | 770-888-0717
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Fax | 770-888-0763
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Provider Business Mailing Address
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Address Line | 6045 SOUTHARD TRACE
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City | CUMMING
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State | GA
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Zip | 30040
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Country | US
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Telephone | 770-888-0717
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Fax | 770-888-0763
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARANDEEP K MAKKAR
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Credential | D.O
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Telephone | 770-235-1037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 058617
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License Number State | GA
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Taxonomy #2
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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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