| Internal Medicine & Wellness Center Of Ga Llc | |
|
4 Savannah St Winder GA 30680-2480 | |
| (770) 586-0017 | |
| (770) 586-5460 |
| Full Name | Internal Medicine & Wellness Center Of Ga Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 4 Savannah St, Winder, Georgia |
| Authorized Official Name and Position | Taiwanna Brown-bolds (OWNER) |
| Authorized Official Contact | 7705860017 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine & Wellness Center Of Ga Llc 4 Savannah St Winder GA 30680-2480 Ph: (770) 586-0017 | Internal Medicine & Wellness Center Of Ga Llc 4 Savannah St Winder GA 30680-2480 Ph: (770) 586-0017 |
| NPI Number | 1700171485 |
|---|---|
| Provider Enumeration Date | 06/10/2011 |
| Last Update Date | 06/10/2011 |
| Medicare PECOS PAC ID | 6406025394 |
|---|---|
| Medicare Enrollment ID | O20110810000488 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700171485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Taiwanna G Brown-bolds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104911817 PECOS PAC ID: 1557380581 Enrollment ID: I20051118000112 |
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