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NPI Code Detail

MEDICARE: HEALTHMED INTERVENTIONAL PAIN MANAGEMENT

MEDICARE: HEALTHMED INTERVENTIONAL PAIN MANAGEMENT
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
1208VP0000XPain Medicine Physician

General Provider Information

NPI Number : 1811454820
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHMED INTERVENTIONAL PAIN MANAGEMENT
Provider Business Mailing Address
First Line : 4535 WINTERS CHAPEL RD STE B
Second Line :
City : DORAVILLE
State : GA
Zip : 30360-2705
Country : US
Telephone Number : 404-401-8521
Fax Number : 561-790-8553
Provider Business Practice Location Address
First Line : 4535 WINTERS CHAPEL RD STE B
Second Line :
City : DORAVILLE
State : GA
Zip : 30360-2705
Country : US
Telephone Number : 404-401-8521
Fax Number : 561-790-8553
Authorized Official
Title or Position : OWNER
Name : FITZCLARENCE HARPER
Credential : MD
Telephone Number : 561-228-1945
Provider Enumeration Date : 02/26/2019
Last Update Date : 02/26/2019

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Directions to “HEALTHMED INTERVENTIONAL PAIN MANAGEMENT ” Practice Location

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