Organization
MID PHYSICIAN NETWORK (IN), LLC
Active
Parent organization
MYIDEALDOCTOR, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MYIDEALDOCTOR, LLC
Authorized official
MR. ADRIAN DAVIS (CEO)
(678) 491-2804
Entity
Organization
Contact information
Practice address
5665 NEW NORTHSIDE DR, SUITE 520, ATLANTA, GA 30328-5831
(855) 879-4332
Mailing address
5665 NEW NORTHSIDE DR, SUITE 520, ATLANTA, GA 30328-5831
(855) 879-4332
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/23/2016
Last updated
11/23/2016
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