Organization
PEACHTREE PRIMARY CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANILA H QIDWAI MD (OWNER)
(770) 676-6838
Entity
Organization
Contact information
Practice address
1570 OLD ALABAMA RD, ROSWELL, GA 30076-2107
(770) 676-6838
(770) 676-6840
Mailing address
1570 OLD ALABAMA RD, SUITE 105, ROSWELL, GA 30076-2107
(770) 676-6838
(770) 676-6840
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
065787
GA
Other
Enumeration date
12/21/2011
Last updated
05/04/2012
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