Organization
NG MEDICAL GROUP, P.C.
Active
Other names
Russell Medical
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDEE NICOLE URRUTIA M.D. (PRESIDENT / OWNER)
(770) 771-5050
Entity
Organization
Contact information
Practice address
4355 BROWNS BRIDGE RD STE 1, CUMMING, GA 30041-4554
(770) 771-5050
(770) 771-5051
Mailing address
4355 BROWNS BRIDGE RD STE 1, CUMMING, GA 30041-4554
(770) 771-5050
(770) 771-5051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D2043142
CLIA
GA
01
—
202G709404
PTAN MEDICARE
GA
Enumeration date
04/03/2012
Last updated
07/14/2022
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