Organization
INTERNAL MEDICINE ASSOCIATES OF LAWRENCEVILLE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AGBOR N EGBEWATT M.D (PRESIDENT)
(770) 338-5070
Entity
Organization
Contact information
Practice address
748 OLD NORCROSS RD, SUITE 150, LAWRENCEVILLE, GA 30046-3393
(770) 338-5070
(770) 338-2568
Mailing address
748 OLD NORCROSS RD, SUITE 150, LAWRENCEVILLE, GA 30046-3393
(770) 338-5070
(770) 338-2568
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
038744
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000631463C
—
ID
Enumeration date
07/23/2008
Last updated
03/10/2011
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