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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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