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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
4000 SHAKERAG HL, SUITE 301, PEACHTREE CITY, GA 30269-4047
(770) 486-7192
(770) 486-7110
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
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
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
RN115077
GA
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/29/2010
Last updated
04/11/2023
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