Organization
PMC MEDICAL & DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY LEACH (TEAM FINANCE LEADER)
(678) 736-6342
Entity
Organization
Contact information
Practice address
4646 N SHALLOWFORD RD STE 100, ATLANTA, GA 30338-6308
(770) 392-9805
Mailing address
4646 N SHALLOWFORD RD STE 100, ATLANTA, GA 30338-6308
(770) 392-9805
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
026769
GA
208D00000X
General Practice Physician
038861
GA
Other
Enumeration date
03/07/2013
Last updated
03/07/2013
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