Organization
ELITE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIAN SUTER (OWNER)
(404) 561-5714
Entity
Organization
Contact information
Practice address
3965 GLEN PARK DR, LITHONIA, GA 30038-3692
(404) 561-5714
Mailing address
3965 GLEN PARK DR, LITHONIA, GA 30038-3692
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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