| Joseph L. Micca, Md | |
|
1938 Rand Ridge Ct Marietta GA 30062-5340 | |
| (770) 596-7328 | |
| (770) 809-5063 |
| Full Name | Joseph L. Micca, Md |
|---|---|
| Speciality | Internal Medicine |
| Location | 1938 Rand Ridge Ct, Marietta, Georgia |
| Authorized Official Name and Position | Joseph L Micca (OWNER) |
| Authorized Official Contact | 7708882524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joseph L. Micca, Md Po Box 3253 Alpharetta GA 30023-3253 Ph: (770) 888-2524 | Joseph L. Micca, Md 1938 Rand Ridge Ct Marietta GA 30062-5340 Ph: (770) 596-7328 |
| NPI Number | 1386917425 |
|---|---|
| Provider Enumeration Date | 02/21/2012 |
| Last Update Date | 02/21/2012 |
| Medicare PECOS PAC ID | 3870757784 |
|---|---|
| Medicare Enrollment ID | O20120605000549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386917425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 39179 (Georgia) | Primary |
| Provider Name | Joseph Louis Micca |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376655712 PECOS PAC ID: 4789848698 Enrollment ID: I20120605000566 |
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