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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