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General NPI Number Information
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NPI Number | 1659552115
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Entity Type | Organization
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Legal Business Name | CLAIRMONT MEDICAL CLINIC LLC BELACHEW YOHANNES A EI AL MBR
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3490 CLAIRMONT RD
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City | ATLANTA
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State | GA
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Zip | 30319
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Country | US
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Telephone | 404-477-1218
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Fax |
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Provider Business Mailing Address
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Address Line | 3490 CLAIRMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30319-3758
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Country | US
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Telephone | 404-477-1218
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. YOHANNES A BELACHEW
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Credential | MD
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Telephone | 404-477-1218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | GA
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