Organization
IDEAL MEDCLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SALCIDO (CFO)
(678) 314-7235
Entity
Organization
Contact information
Practice address
6572 RIVER PARK DR STE 102, RIVERDALE, GA 30274-2214
(770) 629-2296
Mailing address
6572 RIVER PARK DR STE 102, RIVERDALE, GA 30274-2214
(770) 629-2296
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
11/03/2021
Last updated
11/03/2021
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