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Organization
PIEDMONT MEDICAL CARE CORPORATION
Active
Organization
PIEDMONT MEDICAL CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY AQUINO (DIRECTOR, PROVIDER ENROLLMENT)
(470) 895-0214
Entity
Organization
Contact information
Practice address
1314 CONCORD RD SE, SMYRNA, GA 30080-4361
(770) 333-8889
Mailing address
PO BOX 102321, ATLANTA, GA 30368-4361
(770) 801-2500
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
261QP2300X
Primary Care Clinic/Center
RN130109
GA
Other
Enumeration date
06/09/2011
Last updated
04/11/2023
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