Organization
FOUNDATION MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NAOMI MONTANEZ (AUTHORIZED OFFICIAL/OFFICE MANAGER)
(804) 506-0526
Entity
Organization
Contact information
Practice address
160 CLAIREMONT AVE STE 200, DECATUR, GA 30030-2546
(706) 534-8574
Mailing address
160 CLAIREMONT AVE STE 200, DECATUR, GA 30030-2546
(804) 506-0526
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/28/2020
Last updated
06/25/2023
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