| Faebris Medical & Community Education | |
|
3939 Lavista Rd Ste E-310 Tucker GA 30084-5162 | |
| (770) 905-2347 | |
| Not Available |
| Full Name | Faebris Medical & Community Education |
|---|---|
| Speciality | Internal Medicine |
| Location | 3939 Lavista Rd Ste E-310, Tucker, Georgia |
| Authorized Official Name and Position | Zandraetta L Tims-cook (OWNER) |
| Authorized Official Contact | 7709052347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Faebris Medical & Community Education 3939 Lavista Rd Ste E-310 Tucker GA 30084-5162 Ph: (770) 905-2347 | Faebris Medical & Community Education 3939 Lavista Rd Ste E-310 Tucker GA 30084-5162 Ph: (770) 905-2347 |
| NPI Number | 1942635081 |
|---|---|
| Provider Enumeration Date | 09/09/2013 |
| Last Update Date | 09/09/2013 |
| Medicare PECOS PAC ID | 5799919544 |
|---|---|
| Medicare Enrollment ID | O20131009001544 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942635081 | NPI | - | NPPES |
| 15382816338 | Other | NPI INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Zandraetta L Tims-cook |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538216338 PECOS PAC ID: 9234322710 Enrollment ID: I20101015000803 |
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