Organization
HERITAGE MEDICAL SOLUTIONS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE AJONY B.S./HND (PRESIDENT/C.E.O)
(678) 889-4944
Entity
Organization
Contact information
Practice address
4330 SOUTH LEE STREET, BLDG 600, BUFORD, GA 30518-5754
(678) 889-4944
(678) 889-4946
Mailing address
4330 SOUTH LEE STREET, BLDG 600, BUFORD, GA 30518-5754
(678) 889-4944
(678) 889-4946
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
047776
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097274712A
—
GA
01
—
1023170842
NPI INDIVIDUAL
GA
01
—
11662044
CAQH
GA
Enumeration date
01/18/2008
Last updated
04/07/2009
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