Organization
EASTSIDE INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRIETTA MADDOX (OFFICE MANAGER)
(678) 625-7800
Entity
Organization
Contact information
Practice address
2080 EASTSIDE DR, SUITE A, CONYERS, GA 30013-1953
(678) 625-7800
(678) 625-7888
Mailing address
2080 EASTSIDE DR, SUITE A, CONYERS, GA 30013-1953
(678) 625-7800
(678) 625-7888
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
GA
Other
Enumeration date
01/04/2007
Last updated
07/21/2022
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