Organization
CORPORATE MEDICAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BANOV MD (OWNER)
(770) 270-1622
Entity
Organization
Contact information
Practice address
2151A IDLEWOOD RD, TUCKER, GA 30084-4816
(770) 270-1622
Mailing address
3025 BRECKINRIDGE BLVD, DULUTH, GA 30096-4979
(678) 226-0082
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
033519
GA
Other
Enumeration date
06/10/2006
Last updated
08/22/2020
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