# NISSI FAMILY MEDICINE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1083010201
- **Authorized official:** MARGA NGWANG MD (OWNER/MEDICAL DIRECTOR)
- **Authorized official phone:** (678) 540-7597

## Contact information

- **Practice address:** 1810 MULKEY RD, SUITE 105, AUSTELL, GA 30106-1151
- **Practice address phone:** (678) 540-7597
- **Practice address fax:** (770) 645-9802
- **Mailing address:** 1810 MULKEY RD, SUITE 105, AUSTELL, GA 30106-1151
- **Mailing address phone:** (678) 540-7597
- **Mailing address fax:** (770) 645-9802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/16/2014
- **Last updated:** 11/16/2014