# ILLUMINATE MEDICAL LLC

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

## Provider details

- **NPI number:** 1831928126
- **Authorized official:** SETH M ILLU MD (PRESIDENT)
- **Authorized official phone:** (470) 846-3790

## Contact information

- **Practice address:** 5257 BOWMAN SPRINGS TRL, FLOWERY BRANCH, GA 30542-5193
- **Practice address phone:** (470) 846-3790
- **Mailing address:** 5257 BOWMAN SPRINGS TRL, FLOWERY BRANCH, GA 30542-5193
- **Mailing address phone:** (470) 846-3790

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2024
- **Last updated:** 07/26/2024