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General NPI Number Information
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NPI Number | 1902811748
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Entity Type | Organization
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Legal Business Name | TMC GASTROENTEROLOGY ASSOCIATES INC
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 05/14/2008
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Provider Practice Location Address
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Address Line | 690 DALLAS HWY SUITE 304
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City | VILLA RICA
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State | GA
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Zip | 30180-1209
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Country | US
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Telephone | 770-456-3786
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Fax | 770-456-3806
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Provider Business Mailing Address
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Address Line | 119 AMBULANCE DR SUITE 202
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City | CARROLLTON
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State | GA
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Zip | 30117-3857
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Country | US
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Telephone |
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Fax | 770-836-9261
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Authorized Official
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Title or Position | DIRECTOR OF FINANCIAL OPERATION
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Name | DEBBI PEARE
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Credential |
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Telephone | 770-838-8554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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