MEDICARE: GIRISH G PORE' M.D.

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	207RG0100X	Gastroenterology Physician	56868	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	N24675	OTHER	GA	WELLCARE
2	7858986	OTHER	GA	CIGNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	198491	OTHER	GA	BCBS
5	7975508	OTHER	GA	AETNA

General Provider Information

NPI Number	:	1881627800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIRISH G PORE' M.D.

Provider Business Mailing Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	SUITE 1600
City	:	ATLANTA
State	:	GA
Zip	:	30308-2208
Country	:	US
Telephone Number	:	404-888-7575
Fax Number	:	404-253-6896

Provider Business Practice Location Address
First Line	:	3890 JOHNS CREEK PKWY
Second Line	:	SUITE 250
City	:	SUWANEE
State	:	GA
Zip	:	30024-1284
Country	:	US
Telephone Number	:	678-775-0293
Fax Number	:	678-775-0297

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/07/2023

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Directions to “ GIRISH G PORE' M.D.” Practice Location

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