| Ambrosia Functional Medicine Llc | |
|
1668 Mulkey Rd Ste G Austell GA 30106-1163 | |
| (404) 585-4964 | |
| (404) 581-5838 |
| Full Name | Ambrosia Functional Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1668 Mulkey Rd Ste G, Austell, Georgia |
| Authorized Official Name and Position | Chibuzor Steve Eke (MANAGING PARTNER) |
| Authorized Official Contact | 4045854964 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ambrosia Functional Medicine Llc 5878 Graywood Cir Se Mableton GA 30126-2894 Ph: (404) 585-4964 | Ambrosia Functional Medicine Llc 1668 Mulkey Rd Ste G Austell GA 30106-1163 Ph: (404) 585-4964 |
| NPI Number | 1073270997 |
|---|---|
| Provider Enumeration Date | 11/27/2021 |
| Last Update Date | 03/17/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073270997 | NPI | - | NPPES |
| 1134670474 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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