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Organization

PRIMARY FAMILY MEDICINE L.L.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FERIAL WALID M.D (M.D)
(478) 922-6685
Entity
Organization

Contact information

Practice address
110 WOODCREST BLVD, WARNER ROBINS, GA 31093-8824
(478) 922-6685
(478) 922-6686
Mailing address
4856 GUERRY DR, MACON, GA 31210-4104
(478) 960-1804

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
55461
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
163454222C
GA
01
511G700847
MEDICARE PTAN
Enumeration date
07/14/2008
Last updated
01/08/2009
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