| Pvc Georgia LLC | |
|
1640 Powers Ferry Rd Se Ste 100 Marietta GA 30067-5491 | |
| (212) 734-6621 | |
| Not Available |
| Full Name | Pvc Georgia LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1640 Powers Ferry Rd Se Ste 100, Marietta, Georgia |
| Authorized Official Name and Position | Eliezer Halpert (PARTER) |
| Authorized Official Contact | 7185141432 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pvc Georgia LLC 1640 Powers Ferry Rd Se Ste 100 Marietta GA 30067-5491 | Pvc Georgia LLC 1640 Powers Ferry Rd Se Ste 100 Marietta GA 30067-5491 Ph: (212) 734-6621 |
| NPI Number | 1447130224 |
|---|---|
| Provider Enumeration Date | 09/03/2025 |
| Last Update Date | 09/03/2025 |
| Certification Date | 09/03/2025 |
| Medicare PECOS PAC ID | 4789176009 |
|---|---|
| Medicare Enrollment ID | O20251124004357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447130224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | James M Poindexter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295723005 PECOS PAC ID: 8921079195 Enrollment ID: I20050330000339 |
| Provider Name | Walaya C Methodius-rayford |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1407091499 PECOS PAC ID: 7416013545 Enrollment ID: I20090225000568 |
| Provider Name | Talja Sharra Fletcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447748066 PECOS PAC ID: 0345667234 Enrollment ID: I20200824001035 |
| Provider Name | Anna Banni Fofung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760965198 PECOS PAC ID: 7012382120 Enrollment ID: I20230403001536 |
| Provider Name | Alishia Marie Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942186564 PECOS PAC ID: 4688166903 Enrollment ID: I20251124004401 |
| Provider Name | Eric Berkowitz |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1508805805 PECOS PAC ID: 3971508433 Enrollment ID: I20251202003048 |
| Provider Name | Eliezer Halpert |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1881848687 PECOS PAC ID: 2567649833 Enrollment ID: I20251231002793 |
| Provider Name | Iftikhar Ahmad |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1922070457 PECOS PAC ID: 2668442120 Enrollment ID: I20260610003368 |
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