Organization
RE VIVIFY MD HEALTH AND WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIJAH BURRIS MD (FAMILY AND AESTHETIC MEDICINE)
(678) 850-3509
Entity
Organization
Contact information
Practice address
898 OAK ST SW, ATLANTA, GA 30310-1959
(678) 850-3509
(678) 850-3509
Mailing address
898 OAK ST SW UNIT 3425, ATLANTA, GA 30310-1974
(678) 850-3509
(678) 850-3509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0505X
Adult Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207QP0002X
Physician Nutrition Specialist (Family Medicine)
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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