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General NPI Number Information
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NPI Number | 1952814352
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Entity Type | Organization
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Legal Business Name | MEDICI SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 12/11/2018
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Provider Practice Location Address
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Address Line | 792 CHURCH ST NE STE 101
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City | MARIETTA
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State | GA
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Zip | 30060-7291
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Country | US
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Telephone | 844-328-4624
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 GEORGE BUSBEE PKWY NW STE 50
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City | KENNESAW
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State | GA
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Zip | 30144-6910
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Country | US
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Telephone | 844-328-4624
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Fax | 770-882-2576
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Authorized Official
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Title or Position | CMO
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Name | SONNY DOSANJH
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Credential | MD
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Telephone | 844-328-4624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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