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General NPI Number Information
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NPI Number | 1801045687
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Entity Type | Organization
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Legal Business Name | IN EXCESS LLC
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 2221 PEACHTREE RD NE STE D647
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City | ATLANTA
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State | GA
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Zip | 30309-1133
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Country | US
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Telephone | 407-583-2046
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Fax |
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Provider Business Mailing Address
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Address Line | 2221 PEACHTREE RD NE STE D647
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City | ATLANTA
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State | GA
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Zip | 30309-1133
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Country | US
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Telephone | 407-583-2046
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS ZIRLEYN PANADE
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Credential |
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Telephone | 404-583-2046
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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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