Organization
ATLANTA MEN'S CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA REEDER CCMA, CBCS (PRACTICE ADMINISTRATOR)
(470) 589-7120
Entity
Organization
Contact information
Practice address
1800 PEACHTREE RD NE STE 660, ATLANTA, GA 30309
(470) 589-7120
(844) 350-6954
Mailing address
4411 SUWANEE DAM RD STE 440, SUWANEE, GA 30024-8706
(470) 589-7120
(844) 350-6954
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255728994
NPI
GA
Enumeration date
07/27/2022
Last updated
01/19/2024
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