# MY DOCTORS CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peach Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497183941
- **Authorized official:** KETAN GHIA (MANAGER)
- **Authorized official phone:** (678) 473-0715

## Contact information

- **Practice address:** 2320 ATLANTA HWY, SUITE - 105, CUMMING, GA 30040-6339
- **Practice address phone:** (678) 473-0715
- **Mailing address:** 1754 MORNINGDALE CIR, NONE, DULUTH, GA 30097-5260
- **Mailing address phone:** (678) 473-0715

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | 052826 | GA | — |
| 207Q00000X | Family Medicine Physician | 61431 | GA | Yes |
| 207R00000X | Internal Medicine Physician | 052826 | GA | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 052826 | GA | — |
| 2080P0214X | Pediatric Pulmonology Physician | 63536 | GA | — |

## Other

- **Enumeration date:** 10/19/2013
- **Last updated:** 01/16/2014