Organization
GWINNETT EAR NOSE & THROAT, LLC
Active
Parent organization
GWINNETT MEDICAL GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GWINNETT MEDICAL GROUP, INC
Authorized official
STEVEN A RUBIN (EXECUTIVE DIRECTOR)
(470) 325-0150
Entity
Organization
Contact information
Practice address
3855 PLEASANT HILL RD, SUITE 280, DULUTH, GA 30096-1407
(470) 325-0100
(470) 325-0193
Mailing address
3855 PLEASANT HILL RD, SUITE 280, DULUTH, GA 30096-1407
(470) 325-0100
(470) 325-0193
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
01/28/2014
Last updated
01/28/2014
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