MEDICARE: TRANSITIONAL CARE PHYSICIANS OF GEORGIA PC

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	174400000X	Specialist	66531	GA

General Provider Information

NPI Number	:	1619317542
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANSITIONAL CARE PHYSICIANS OF GEORGIA PC

Provider Business Mailing Address
First Line	:	PO BOX 5856
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	31107-0856
Country	:	US
Telephone Number	:	888-772-0076
Fax Number	:	770-751-8014

Provider Business Practice Location Address
First Line	:	704 BREEDLOVE DR
Second Line	:	STE A
City	:	MONROE
State	:	GA
Zip	:	30655-2054
Country	:	US
Telephone Number	:	888-772-0076
Fax Number	:	770-751-8014

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	DR. AMAR V MOHAN
Credential	:	MD
Telephone Number	:	888-772-0076

Provider Enumeration Date	:	06/25/2013
Last Update Date	:	06/21/2024

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