| Southern Medical Clinic Llc | |
|
1136 Cleveland Ave Suite 221 East Point GA 30344-3618 | |
| (404) 761-1550 | |
| (678) 233-1633 |
| Full Name | Southern Medical Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1136 Cleveland Ave, East Point, Georgia |
| Authorized Official Name and Position | Chirag R Patel (PRESIDENT) |
| Authorized Official Contact | 4047611550 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Medical Clinic Llc 1136 Cleveland Ave Suite 221 East Point GA 30344-3618 Ph: (404) 761-1550 | Southern Medical Clinic Llc 1136 Cleveland Ave Suite 221 East Point GA 30344-3618 Ph: (404) 761-1550 |
| NPI Number | 1801908157 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 10/20/2016 |
| Medicare PECOS PAC ID | 0547243941 |
|---|---|
| Medicare Enrollment ID | O20101110000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801908157 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Chirag R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225008758 PECOS PAC ID: 9830177096 Enrollment ID: I20040713000780 |
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