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Organization
RE VIVIFY MD HEALTH AND WELLNESS CENTER
Active
Organization
RE VIVIFY MD HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIJAH BURRIS MD (FAMILY AND AESTHETIC MEDICINE)
(678) 850-3509
Entity
Organization
Contact information
Practice address
898 OAK ST SW, ATLANTA, GA 30310-1959
(678) 850-3509
(678) 850-3509
Mailing address
898 OAK ST SW UNIT 3425, ATLANTA, GA 30310-1974
(678) 850-3509
(678) 850-3509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0505X
Adult Medicine Physician
—
NULL
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
NULL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207QP0002X
Physician Nutrition Specialist (Family Medicine)
—
NULL
207QP0002X
Physician Nutrition Specialist (Family Medicine)
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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