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NPI Code Detail

MEDICARE: PROGRESSIVE MEDICAL CENTER, PC

MEDICARE: PROGRESSIVE MEDICAL CENTER, 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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician
2208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1649413238
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRESSIVE MEDICAL CENTER, PC
Provider Business Mailing Address
First Line : 4646 N SHALLOWFORD RD
Second Line : #500
City : ATLANTA
State : GA
Zip : 30338-6308
Country : US
Telephone Number : 770-676-6000
Fax Number :
Provider Business Practice Location Address
First Line : 4646 N SHALLOWFORD RD
Second Line : #500
City : ATLANTA
State : GA
Zip : 30338-6308
Country : US
Telephone Number : 770-676-6000
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : DR. FRANK PAUL MATALONE
Credential : D.O.
Telephone Number : 770-676-6000
Provider Enumeration Date : 04/12/2009
Last Update Date : 04/12/2009

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Directions to “PROGRESSIVE MEDICAL CENTER, PC ” Practice Location

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