MEDICARE: GCMD MEDICAL CENTERS LLC

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

General Provider Information

NPI Number	:	1679303226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GCMD MEDICAL CENTERS LLC

Provider Business Mailing Address
First Line	:	2045 PEACHTREE RD NE STE 310
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-1407
Country	:	US
Telephone Number	:	404-222-9914
Fax Number	:	770-504-4105

Provider Business Practice Location Address
First Line	:	1000 WYNGATE PKWY STE 210
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6983
Country	:	US
Telephone Number	:	678-384-7305
Fax Number	:	770-928-9109

Authorized Official
Title or Position	:	ADMINISTRATION SUPPORT
Name	:	PAOLA PAZ
Credential	:
Telephone Number	:	305-316-3380

Provider Enumeration Date	:	08/07/2024
Last Update Date	:	04/04/2025

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