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NPI Code Detail

MEDICARE: PAUL Q. CERNY M.D.

MEDICARE: PAUL Q. CERNY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician051760GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093707473
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL Q. CERNY M.D.
Provider Business Mailing Address
First Line : PO BOX 742616
Second Line :
City : ATLANTA
State : GA
Zip : 30374-2616
Country : US
Telephone Number : 770-219-8420
Fax Number :
Provider Business Practice Location Address
First Line : 4919 ATLANTA HWY
Second Line :
City : FLOWERY BRANCH
State : GA
Zip : 30542-3328
Country : US
Telephone Number : 770-965-9222
Fax Number : 770-965-8811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 02/01/2021

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