Organization
PIEDMONT MEDICAL CARE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY AQUINO (DIRECTOR OF PROVIDER ENROLLMENT)
(470) 895-0214
Entity
Organization
Contact information
Practice address
240 N HIGHLAND AVE NE STE F, ATLANTA, GA 30307-5625
(404) 658-9840
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
(770) 801-2500
(770) 803-2121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030651Y
—
GA
Enumeration date
05/08/2006
Last updated
04/11/2023
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