Organization
TMC INFECTIOUS DISEASES OF WEST GEORGIA
Active
Organization
TMC INFECTIOUS DISEASES OF WEST GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBI MACALUSO PEARE (DIRECTOR OF FINANCIAL OPERATIONS)
(770) 838-8554
Entity
Organization
Contact information
Practice address
705 DIXIE ST, C/O ICU, CARROLLTON, GA 30117-3818
(770) 836-9666
(770) 838-8922
Mailing address
119 AMBULANCE DR, AUITE 202, CARROLLTON, GA 30117-3857
(770) 836-9250
(770) 836-9261
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG2920
MEDICARE ID
GA
Enumeration date
06/28/2006
Last updated
05/14/2008
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