Organization
WINDER INTERNAL MEDICINE AND GERIATRICS CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RASHA G AL SAMARA MD (PRESIDENT)
(770) 586-0310
Entity
Organization
Contact information
Practice address
30 SATELLITE DR, SUITE 100, WINDER, GA 30680-6211
(770) 586-0310
(770) 586-0312
Mailing address
30 SATELLITE DR, SUITE 100, WINDER, GA 30680-6211
(770) 586-0310
(770) 586-0312
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
063592
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063592
MEDICAL LICENSE
GA
Enumeration date
03/12/2010
Last updated
02/19/2014
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