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Organization

INFECTIOUS DISEASES ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAM TEMPLETON (PRACTICE ADMINISTRATOR)
(770) 991-1500
Entity
Organization

Contact information

Practice address
6285 GARDEN WALK BLVD, STE A, RIVERDALE, GA 30274-2612
(770) 991-1500
(770) 991-9047
Mailing address
6285 GARDEN WALK BLVD, STE A, RIVERDALE, GA 30274-2612
(770) 991-1500
(770) 991-9047

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
019754
GA
207RI0200X
Infectious Disease Physician
020689
GA
207RI0200X
Infectious Disease Physician
63616
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427064583
NPI
GA
01
1538216338
NPI
01
1548276603
NPI
GA
Enumeration date
05/17/2007
Last updated
06/22/2011
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