Organization
MID PHYSICIAN NETWORK (WV), PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN DAVIS (CEO)
(678) 491-2804
Entity
Organization
Contact information
Practice address
5665 NEW NORTHSIDE DR, SUITE 520, ATLANTA, GA 30328-5831
(678) 491-2804
Mailing address
5665 NEW NORTHSIDE DR, SUITE 520, ATLANTA, GA 30328-5831
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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