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General NPI Number Information
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NPI Number | 1992536213
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Entity Type | Organization
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Legal Business Name | SOMERSET MEDICAL LLC
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 659 AUBURN AVE NE STE 505
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City | ATLANTA
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State | GA
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Zip | 30312-1903
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Country | US
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Telephone | 404-444-9418
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Fax |
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Provider Business Mailing Address
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Address Line | 815 MYRTLE ST NE
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City | ATLANTA
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State | GA
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Zip | 30308-4309
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Country | US
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Telephone | 404-444-9418
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Fax |
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Authorized Official
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Title or Position | FOUNDER / PHYSICIAN
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Name | DR. NICHOLAS CHURCH
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Credential | MD
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Telephone | 404-444-9418
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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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