# NOUVEAU MEDIC LLC

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

## Provider details

- **NPI number:** 1104100395
- **Authorized official:** DR. JOY S EDWARDS NMD, APRN,MPH (CLINICAL MANAGER)
- **Authorized official phone:** (678) 653-0045

## Contact information

- **Practice address:** 600 PHIPPS BLVD NE APT 1304, ATLANTA, GA 30326-3342
- **Practice address phone:** (678) 653-0045
- **Practice address fax:** (404) 393-3640
- **Mailing address:** 600 PHIPPS BLVD NE APT 1304, ATLANTA, GA 30326-3342
- **Mailing address phone:** (678) 653-0045
- **Mailing address fax:** (404) 393-3640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician | 051126 | GA | — |
| 207QA0505X | Adult Medicine Physician | 051126 | GA | — |
| 207RI0001X | Clinical & Laboratory Immunology (Internal Medicine) Physician | — | NULL | — |
| 207RI0001X | Clinical & Laboratory Immunology (Internal Medicine) Physician | — | — | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/05/2011
- **Last updated:** 02/01/2022