Organization
PRIMARY CARE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENISE NICOLE SHELTON (OFFICE MANAGER)
(678) 705-2355
Entity
Organization
Contact information
Practice address
315 BOULEVARD NE, SUITE 310, ATLANTA, GA 30312
(678) 705-2355
(678) 705-2378
Mailing address
315 BOULEVARD NE, SUITE 310, ATLANTA, GA 30312
(678) 705-2355
(678) 705-2378
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
050559
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000930234B
—
GA
Enumeration date
03/12/2008
Last updated
12/27/2016
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