Organization
PEACHTREE MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANEESH M GUPTA MD (MEMBER)
(678) 799-7797
Entity
Organization
Contact information
Practice address
657 VILLAGE MANOR PL, SUWANEE, GA 30024-6789
(678) 799-7797
Mailing address
657 VILLAGE MANOR PL, SUWANEE, GA 30024-6789
(678) 799-7797
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053231
GA
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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