Organization
PREMIER SOUTH MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EWAUL BARRINGTON PERSAUD JR. M.D. (PRESIDENT)
(404) 344-6000
Entity
Organization
Contact information
Practice address
3885 PRINCETON LAKES WAY SW, SUITE 412, ATLANTA, GA 30331-5589
(404) 344-6000
(404) 344-6575
Mailing address
8750 NW 36TH ST, SUITE 300, DORAL, FL 33178-2425
(786) 641-5348
(305) 615-1121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
040754
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00318272A
—
GA
Enumeration date
01/26/2007
Last updated
12/19/2016
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