| Maxa Internal Medicine Associates PC | |
|
3505 Duluth Park Ln Building 4, Ste 400 Duluth GA 30096-3201 | |
| (678) 597-3180 | |
| (678) 597-3181 |
| Full Name | Maxa Internal Medicine Associates PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 3505 Duluth Park Ln, Duluth, Georgia |
| Authorized Official Name and Position | Ashleigh Maxa (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6785973180 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maxa Internal Medicine Associates PC 3505 Duluth Park Ln Building 4, Ste 400 Duluth GA 30096-3201 Ph: (678) 597-3180 | Maxa Internal Medicine Associates PC 3505 Duluth Park Ln Building 4, Ste 400 Duluth GA 30096-3201 Ph: (678) 597-3180 |
| NPI Number | 1902957152 |
|---|---|
| Provider Enumeration Date | 01/15/2007 |
| Last Update Date | 07/19/2011 |
| Medicare PECOS PAC ID | 7113831017 |
|---|---|
| Medicare Enrollment ID | O20031114000565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902957152 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Benigno B Bobon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487645032 PECOS PAC ID: 3274547252 Enrollment ID: I20060130000068 |
| Provider Name | Richard Reid Maxa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144371386 PECOS PAC ID: 1254245152 Enrollment ID: I20111026000939 |
| Provider Name | Joel Kent Phillips |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518367473 PECOS PAC ID: 8527280296 Enrollment ID: I20141112002517 |
| Provider Name | Kelsey Lynne Greeff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770108805 PECOS PAC ID: 9739598442 Enrollment ID: I20210511000142 |
| Provider Name | Elizabeth Rose Duignam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972300051 PECOS PAC ID: 0042724445 Enrollment ID: I20250708003716 |
| Provider Name | Ambree E Lavelle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922824473 PECOS PAC ID: 0244714673 Enrollment ID: I20260324001219 |
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