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Organization

ALPHA FAMILY MEDICINE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHYLA REDDY MD (OWNER)
(251) 459-3233
Entity
Organization

Contact information

Practice address
480 N MAIN ST STE 202, ALPHARETTA, GA 30009-8386
(678) 619-1974
(678) 619-1975
Mailing address
PO BOX 1385, ALPHARETTA, GA 30009-1385
(678) 619-1974
(678) 619-1975

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
71622
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009932265
AL
01
051518001
MEDICARE PROVIDER NUMBER
01
1295774305
PERSONAL NPI NUMBER
Enumeration date
07/21/2014
Last updated
07/21/2014
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