Organization
SOUTHEASTERN LUNG CARE PC
Active
Other names
The Sleep Disorders Centers of Southeastern Lung Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA LYNN DISCORDIA BHA CPC CHCC CMM (CEO ADMINISTRATOR)
(404) 294-4018
Entity
Organization
Contact information
Practice address
1490 MILSTEAD RD NE STE A, CONYERS, GA 30012-3823
(770) 922-2217
(770) 922-1626
Mailing address
1490 MILSTEAD RD NE STE A, CONYERS, GA 30012-3823
(770) 922-2217
(770) 922-1626
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400116
BLUE CROSS BLUE SHIELD
GA
05
—
55001212A
—
GA
Enumeration date
12/09/2005
Last updated
03/06/2019
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