Organization
MIDTOWN MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAMIS IBRAHIM (DIRECTOR)
(404) 343-1649
Entity
Organization
Contact information
Practice address
197 14TH ST NW STE 100, ATLANTA, GA 30318-7827
(404) 343-1649
Mailing address
197 14TH ST NW STE 100, ATLANTA, GA 30318-7827
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
027368
GA
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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