Organization
FAMILY MEDICAL CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALLU MOHAMED JABATI MD (CEO)
(770) 997-2900
Entity
Organization
Contact information
Practice address
5615 OLD NATIONAL HWY STE D, COLLEGE PARK, GA 30349-3817
(770) 997-2900
(404) 767-7053
Mailing address
5615 OLD NATIONAL HWY STE D, COLLEGE PARK, GA 30349-3817
(770) 997-2900
(404) 767-7053
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
058527
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058527
LICENSE NUMBER
GA
Enumeration date
11/03/2006
Last updated
07/16/2015
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