Organization
HERITAGE INTERNAL MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENDA J GARLAND M.D. (OWNER)
(706) 754-3287
Entity
Organization
Contact information
Practice address
396 HWY 441 N, SUITE A, DEMOREST, GA 30535-0579
(706) 754-3287
(706) 754-7646
Mailing address
PO BOX 579, DEMOREST, GA 30535-0579
(706) 754-3287
(706) 754-7646
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22813
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005-114-09B
—
GA
01
—
52415033 002
BCBS PROVIDER NUMBER
GA
Enumeration date
11/30/2005
Last updated
08/22/2020
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