| Covenant Family Medicine | |
|
2098 Teron Trace Suite 150 Dacula GA 30019 | |
| (678) 730-1620 | |
| (678) 730-0858 |
| Full Name | Covenant Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 2098 Teron Trace Suite 150, Dacula, Georgia |
| Authorized Official Name and Position | Henry Song Moon (PARTNER) |
| Authorized Official Contact | 6787301620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Family Medicine 2098 Teron Trace Suite 150 Dacula GA 30019 Ph: (678) 730-1620 | Covenant Family Medicine 2098 Teron Trace Suite 150 Dacula GA 30019 Ph: (678) 730-1620 |
| NPI Number | 1962532085 |
|---|---|
| Provider Enumeration Date | 03/07/2007 |
| Last Update Date | 01/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962532085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
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