Organization
COVENANT EMERGENCY PHYSICIANS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC A CHETTA MD (PRESIDENT)
(706) 754-3113
Entity
Organization
Contact information
Practice address
541 HISTORIC HWY 441, ER DEPARTMENT, DEMOREST, GA 30535
(706) 754-3113
Mailing address
480 BARRON DR, CLARKESVILLE, GA 30523-5501
(706) 754-1011
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DE8501
RRGA
GA
Enumeration date
05/15/2006
Last updated
09/13/2007
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