| Innovative Medical, Inc. | |
|
1300 Peachtree Industrial Blvd Suite 2203 Suwanee GA 30024-4539 | |
| (770) 988-2779 | |
| (678) 730-0229 |
| Full Name | Innovative Medical, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1300 Peachtree Industrial Blvd, Suwanee, Georgia |
| Authorized Official Name and Position | Connie Y Jeon (CLINIC DIRECTOR) |
| Authorized Official Contact | 7709882779 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Medical, Inc. 1300 Peachtree Industrial Blvd Suite 2203 Suwanee GA 30024-4539 Ph: (770) 988-2779 | Innovative Medical, Inc. 1300 Peachtree Industrial Blvd Suite 2203 Suwanee GA 30024-4539 Ph: (770) 988-2779 |
| NPI Number | 1003146143 |
|---|---|
| Provider Enumeration Date | 01/13/2010 |
| Last Update Date | 01/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003146143 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 058168 (Georgia) | Primary |
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