MEDICARE: PREMIER FAMILY CLINIC

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
1	207R00000X	Internal Medicine Physician	46800	GA

Other Identifiers

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

General Provider Information

NPI Number	:	1528113107
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIER FAMILY CLINIC

Provider Business Mailing Address
First Line	:	3646 CHAMBLEE TUCKER RD STE B
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-4406
Country	:	US
Telephone Number	:	770-493-6767
Fax Number	:	770-493-6797

Provider Business Practice Location Address
First Line	:	3646 CHAMBLEE TUCKER RD STE B
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-4406
Country	:	US
Telephone Number	:	770-493-6767
Fax Number	:	770-493-6797

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. NIPUN PATEL
Credential	:
Telephone Number	:	770-493-6767

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	04/25/2026

Similar Medicare Providers

1417990987 — DR. NIPUN PATEL M.D.
Practice Location Address:

3646 CHAMBLEE TUCKER RD STE B
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Practice Phone: 770-493-6767
Practice Fax: 770-493-6797

1609128628 — WHITNEY KATHRYN RIVKIN PA-C
Practice Location Address:

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1053806760 — MRS. JENNIFER NICOLE NUETZEL FNP-C
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3646 CHAMBLEE TUCKER RD STE B
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30341-4406

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Practice Fax:

1508029067 — SIRISHA L. RAJU
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Practice Location Address:

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1508860172 — ROBERT W TOTH DC
Practice Location Address:

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Directions to “PREMIER FAMILY CLINIC ” Practice Location

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