Organization
DEKALB INTERNAL MEDICINE ASSOCIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI M MOHAMED MD (CEO)
(770) 270-4060
Entity
Organization
Contact information
Practice address
1980 MONTREAL RD, TUCKER, GA 30084-5217
(770) 270-4060
(770) 270-4061
Mailing address
1980 MONTREAL RD, TUCKER, GA 30084-5217
(770) 270-4060
(770) 270-4061
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
046623
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00815075B
—
GA
Enumeration date
10/01/2011
Last updated
10/01/2011
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