# PERIMETER NORTH FAMILY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013100130
- **Authorized official:** PADMASHRI KOMANDUR SRINIVASA M.D. (PROVIDER)
- **Authorized official phone:** (770) 623-1331

## Contact information

- **Practice address:** 4375 JOHNS CREEK PKWY, SUITE 320, SUWANEE, GA 30024-6085
- **Practice address phone:** (770) 623-1331
- **Practice address fax:** (770) 623-5674
- **Mailing address:** 4375 JOHNS CREEK PKWY, SUITE 320, SUWANEE, GA 30024-6085
- **Mailing address phone:** (770) 623-1331
- **Mailing address fax:** (770) 623-5674

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 059872 | GA | Yes |

## Other

- **Enumeration date:** 08/22/2007
- **Last updated:** 08/22/2007