Organization
COMPLETE HEALTHCARE OF BUFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM VIRGILIO (OWNER)
(678) 546-8044
Entity
Organization
Contact information
Practice address
3280 HAMILTON MILL RD, SUITE 304, BUFORD, GA 30519-7221
(678) 546-8044
(678) 546-8047
Mailing address
3280 HAMILTON MILL RD, SUITE 304, BUFORD, GA 30519-7221
(678) 546-8044
(678) 546-8047
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
28809
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6706740001
MEDICARE PTAN
GA
Enumeration date
12/09/2011
Last updated
10/22/2012
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