Organization
PRINCETON LAKES INTERNAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA WHITE (MEDICAL BILLER)
(678) 637-9155
Entity
Organization
Contact information
Practice address
3885 PRINCETON LAKES WAY SW, ATLANTA, GA 30331-5589
(404) 344-0059
(404) 344-9195
Mailing address
3885 PRINCETON LAKES WAY SW, ATLANTA, GA 30331-5589
(404) 344-0059
(404) 344-9195
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1538167119
GA
174400000X
Specialist
Primary
1689894883
GA
Other
Enumeration date
12/18/2007
Last updated
12/18/2007
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