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Organization

MEDICAL AESTHETIC CENTER LLC

Active
Parent organization
MEDICAL AESTETIC & WELLNESS CENTER
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDICAL AESTETIC & WELLNESS CENTER
Authorized official
DR. MICHAEL CAL PINELL M.D. (PRESIDENT)
(912) 638-7799
Entity
Organization

Contact information

Practice address
60 CINEMA LANE, SUITE 140, SAINT SIMONS ISLAND, GA 31522-6631
(912) 638-7799
(912) 638-7755
Mailing address
60 CINEMA LANE, SUITE 140, SAINT SIMONS ISLAND, GA 31522-6631
(912) 638-7799
(912) 638-7755

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
058102
GA
207Q00000X
Family Medicine Physician
058102
GA

Other

Enumeration date
04/27/2011
Last updated
05/13/2011
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