| West Cobb Internal Medicine Pc | |
|
5041 Dallas Hwy Bldg 2 Suite E West Cobb Internal Medicine Pc Powder Springs GA 30127 | |
| (770) 218-1880 | |
| (770) 218-1088 |
| Full Name | West Cobb Internal Medicine Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5041 Dallas Hwy, Powder Springs, Georgia |
| Authorized Official Name and Position | Chidambaram Raghavan (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7702181880 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Cobb Internal Medicine Pc 5041 Dallas Highway Bldg 2 Suite E West Cobb Internal Medicine Pc Powder Springs GA 30127 Ph: (770) 218-1880 | West Cobb Internal Medicine Pc 5041 Dallas Hwy Bldg 2 Suite E West Cobb Internal Medicine Pc Powder Springs GA 30127 Ph: (770) 218-1880 |
| NPI Number | 1467524330 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 04/20/2008 |
| Medicare PECOS PAC ID | 5193894590 |
|---|---|
| Medicare Enrollment ID | O20080527000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467524330 | NPI | - | NPPES |
| 00626117A | Medicaid | GA | |
| 4562104 | Other | GA | AETNA |
| 0400005 | Other | GA | UNITED HEALTHCARE |
| 617437 | Other | GA | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 38709 (Georgia) | Primary |
| Provider Name | Chidambaram Raghavan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326237322 PECOS PAC ID: 0648349043 Enrollment ID: I20080527000075 |
| Provider Name | Karan Raghavan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518596683 PECOS PAC ID: 6800206251 Enrollment ID: I20240418001343 |
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