| Grupo Medico De Georgia, Llc | |
|
5955 Jimmy Carter Blvd, Suite 100, Norcross, GA 30071-4641 | |
| (770) 559-3555 | |
| Not Available |
| Full Name | Grupo Medico De Georgia, Llc |
|---|---|
| Type | Facility |
| Speciality | Family Medicine |
| Location | 5955 Jimmy Carter Blvd, Norcross, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639574890 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIR008572 (Georgia) | Secondary |
| 363L00000X | Nurse Practitioner | RN105078 (Georgia) | Secondary |
| 207Q00000X | Family Medicine | 38981 (Georgia) | Primary |
| Provider Name | Bradford M Gould |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396895033 PECOS PAC ID: 6406871615 Enrollment ID: I20051006000847 |
| Provider Name | Muhammad Usman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710373816 PECOS PAC ID: 4880997717 Enrollment ID: I20210507001494 |
| Provider Name | Irina Mocanu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689259517 PECOS PAC ID: 0749663599 Enrollment ID: I20220811003016 |
| Provider Name | Judith Grace Lutumba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093937484 PECOS PAC ID: 4880077312 Enrollment ID: I20220817000176 |
| Provider Name | Christopher S Valentine |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679913628 PECOS PAC ID: 7113367897 Enrollment ID: I20240429000978 |
| Mailing Address | Practice Location Address |
|---|---|
| Grupo Medico De Georgia, Llc 4225 S Lee St Ste B, Buford, GA 30518-3658 Ph: (770) 831-9202 | Grupo Medico De Georgia, Llc 5955 Jimmy Carter Blvd, Suite 100, Norcross, GA 30071-4641 Ph: (770) 559-3555 |