Organization
GWINNETT CENTER MEDICAL ASSOCIATES
Active
Organization
GWINNETT CENTER MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD G PETIT P.A. (PHYSICIAN'S ASSISTANT)
(770) 277-8554
Entity
Organization
Contact information
Practice address
748 OLD NORCROSS RD, SUITE 185, LAWRENCEVILLE, GA 30045-3393
(770) 277-8554
(770) 277-1799
Mailing address
748 OLD NORCROSS RD, SUITE 185, LAWRENCEVILLE, GA 30045-3393
(770) 277-8554
(770) 277-1799
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001435
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00756104B
—
GA
Enumeration date
09/15/2006
Last updated
08/22/2020
Update your record
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