Organization
SPECTRUM INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIUS KOLAWOLE ADEBISI M.D (MEDICAL DIRECTOR)
(678) 319-9901
Entity
Organization
Contact information
Practice address
401 S MAIN ST, SUITE B3, ALPHARETTA, GA 30009-1974
(678) 319-9901
(678) 319-9902
Mailing address
401 S MAIN ST, SUITE B3, ALPHARETTA, GA 30009-1974
(678) 319-9901
(678) 319-9902
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
58939
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390122159B
—
GA
Enumeration date
03/26/2014
Last updated
03/26/2014
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