Organization
DOUGLAS COUNTY FAMILY PRACTICE, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIAM GEORGE MD (PRACTICE ADMINISTRATOR)
(770) 949-5535
Entity
Organization
Contact information
Practice address
3872 HIGHWAY 5, DOUGLASVILLE, GA 30135-3366
(770) 949-5535
(770) 949-9022
Mailing address
3872 HIGHWAY 5, DOUGLASVILLE, GA 30135-3366
(770) 949-5535
(770) 949-9022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023734
LICENSE#DR. MARIAM GEORGE
GA
05
—
085111111G
—
GA
01
—
1972590982
NPI-DR. MARIAM GEORGE
GA
05
—
442225907A
—
GA
Enumeration date
01/24/2007
Last updated
02/11/2015
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