Organization
WELLNESS PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL HUY-DAO NGUYEN M.D., (PHYSICIAN)
(678) 380-9889
Entity
Organization
Contact information
Practice address
5456 JIMMY CARTER BLVD, SUITE 240, NORCROSS, GA 30093-1511
(678) 380-9889
Mailing address
5456 JIMMY CARTER BLVD, SUITE 240, NORCROSS, GA 30093-1511
(678) 380-9889
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
047813
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000884793C
—
GA
01
—
GRP6225
MEDICARE GROUP NO.
GA
01
—
H19592
UPIN
GA
Enumeration date
04/12/2008
Last updated
08/24/2010
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