| Duluth Family Practice LLC | |
|
4470 Satellite Blvd Suite 204 Duluth GA 30096-8851 | |
| (770) 858-5983 | |
| (770) 858-5066 |
| Full Name | Duluth Family Practice LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 4470 Satellite Blvd, Duluth, Georgia |
| Authorized Official Name and Position | Liem CHI Ngo (OWNER) |
| Authorized Official Contact | 7708585983 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Duluth Family Practice LLC 4470 Satellite Blvd Suite 204 Duluth GA 30096-8851 Ph: (770) 858-5983 | Duluth Family Practice LLC 4470 Satellite Blvd Suite 204 Duluth GA 30096-8851 Ph: (770) 858-5983 |
| NPI Number | 1730558735 |
|---|---|
| Provider Enumeration Date | 09/20/2015 |
| Last Update Date | 09/20/2015 |
| Medicare PECOS PAC ID | 9436456332 |
|---|---|
| Medicare Enrollment ID | O20160321000583 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730558735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Liem C Ngo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891950457 PECOS PAC ID: 2567626294 Enrollment ID: I20150324002264 |
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