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General NPI Number Information
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NPI Number | 1710049036
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Entity Type | Organization
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Legal Business Name | GWINNETT CONSULTANTS IN CARDIOLOGY
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 04/16/2013
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Provider Practice Location Address
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Address Line | 631 PROFESSIONAL DRIVE STE 360
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-0000
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Country | US
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Telephone | 770-962-4895
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Fax | 770-962-4792
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Provider Business Mailing Address
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Address Line | 631 PROFESSIONAL DR STE 360
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3367
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Country | US
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Telephone | 770-962-4895
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Fax | 770-962-4792
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. RACHEL A BAHIN
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Credential |
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Telephone | 770-962-4895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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