MEDICARE: ALAN K. CU CHIAM MDPC

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	261Q00000X	Clinic/Center	042554	GA

General Provider Information

NPI Number	:	1548324361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN K. CU CHIAM MDPC

Provider Business Mailing Address
First Line	:	1188 RALPH DAVID ABERNATHY BLVD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-1754
Country	:	US
Telephone Number	:	404-755-8996
Fax Number	:	404-755-0520

Provider Business Practice Location Address
First Line	:	1188 RALPH DAVID ABERNATHY BLVD SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30310-1754
Country	:	US
Telephone Number	:	404-755-8996
Fax Number	:	404-755-0520

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALAN K CU CHIAM
Credential	:	MD
Telephone Number	:	404-755-8996

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	08/22/2020

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