MEDICARE: QUICKMD MEDICAL GROUP PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	103TA0400X	Addiction (Substance Use Disorder) Psychologist
2	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
3	208D00000X	General Practice Physician
4	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1841946621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUICKMD MEDICAL GROUP PA

Provider Business Mailing Address
First Line	:	3865 HOLCOMB BRIDGE RD
Second Line	:
City	:	PEACHTREE CORNERS
State	:	GA
Zip	:	30092-2205
Country	:	US
Telephone Number	:	888-878-4256
Fax Number	:

Provider Business Practice Location Address
First Line	:	1461 RALEIGH ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-1419
Country	:	US
Telephone Number	:	888-878-4256
Fax Number	:

Authorized Official
Title or Position	:	SENIOR MANAGER, CREDENTIALING
Name	:	KATRINA MERRITT
Credential	:
Telephone Number	:	813-596-5726

Provider Enumeration Date	:	03/01/2022
Last Update Date	:	01/15/2024

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Directions to “QUICKMD MEDICAL GROUP PA ” Practice Location

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