Organization
GODEL FIRST MEDICAL CLINICS INC.
Active
Organization
GODEL FIRST MEDICAL CLINICS INC.
Active
Other names
Godel First Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIS IFEANYICHUKWU EFOBI MD (CEO)
(770) 879-7707
Entity
Organization
Contact information
Practice address
1525 E PARK PLACE BLVD, SUITE 300, STONE MOUNTAIN, GA 30087-3453
(770) 879-7707
(770) 879-7708
Mailing address
1525 E PARK PLACE BLVD, SUITE 300, STONE MOUNTAIN, GA 30087-3453
(770) 879-7707
(770) 879-7708
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
594981959A
—
GA
Enumeration date
01/04/2011
Last updated
12/20/2012
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