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Organization
OMS, LLC
Active
Organization
OMS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMID MIDANAKY PA-C (PRESIDENT)
(404) 704-2813
Entity
Organization
Contact information
Practice address
2801 N DECATUR RD, DECATUR, GA 30033-5949
(404) 296-5005
Mailing address
810 WHISPERWOOD TRL, ACWORTH, GA 30102-7586
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8538
GA
Other
Enumeration date
11/09/2017
Last updated
11/09/2017
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