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General NPI Number Information
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NPI Number | 1891247896
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Entity Type | Organization
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Legal Business Name | GWINNETT CONVENIENT CARE LLC
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Dates
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Enumeration Date | 10/26/2016
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1350 SCENIC HWY N STE 266
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City | SNELLVILLE
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State | GA
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Zip | 30078-7924
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Country | US
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Telephone | 470-436-8248
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Fax | 470-729-7562
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Provider Business Mailing Address
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Address Line | 2148 DULUTH HWY SUITE 112
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City | DULUTH
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State | GA
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Zip | 30097-4506
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Country | US
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Telephone | 770-820-1826
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SYED S H ZAIDI
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Credential | MD
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Telephone | 404-242-5666
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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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