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General NPI Number Information
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NPI Number | 1508501206
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Entity Type | Organization
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Legal Business Name | MINDSPRING HEALTH INC.
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Dates
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Enumeration Date | 04/28/2022
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 1074 PONCE DE LEON AVE NE
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City | ATLANTA
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State | GA
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Zip | 30306-4216
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Country | US
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Telephone | 404-618-1854
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Fax |
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Provider Business Mailing Address
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Address Line | 1209 THORNCLIFF CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-8139
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Country | US
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Telephone | 404-618-1854
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. AHMAD UMAIR JANJUA
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Credential | MD
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Telephone | 404-618-1854
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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