Organization
THE CENTER FOR INTERNAL & INTEGRATIVE MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDUARD FATAKHOV M.D. (FOUNDER/CEO)
(770) 256-7069
Entity
Organization
Contact information
Practice address
401 S MAIN ST STE B3, ALPHARETTA, GA 30009-1958
(404) 836-9906
(470) 545-4768
Mailing address
401 S MAIN ST STE B3, ALPHARETTA, GA 30009-1958
(404) 836-9906
(470) 545-4768
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
71068
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295099018
NPI INDIVIDUAL
GA
01
—
1710241658
INDIVIDUAL NPI NUMBER
GA
Enumeration date
02/25/2016
Last updated
02/25/2016
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