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General NPI Number Information
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NPI Number | 1891646626
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Entity Type | Organization
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Legal Business Name | NOVA MEDICAL CLINIC LLC
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Dates
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Enumeration Date | 02/06/2026
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Last Update Date | 02/06/2026
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Provider Practice Location Address
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Address Line | 3455 PEACHTREE INDUSTRIAL BLVD STE 910
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City | DULUTH
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State | GA
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Zip | 30096-6502
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Country | US
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Telephone | 770-584-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 3455 PEACHTREE INDUSTRIAL BLVD STE 910
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City | DULUTH
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State | GA
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Zip | 30096-6502
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Country | US
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Telephone | 770-584-5000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDREW HYUN
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Credential |
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Telephone | 770-367-3325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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