| Weatherstone Medical Care Llc. | |
|
3203 S Cherokee Ln Suite 220 Woodstock GA 30188-4461 | |
| (770) 675-6025 | |
| (770) 675-7814 |
| Full Name | Weatherstone Medical Care Llc. |
|---|---|
| Speciality | Family Medicine |
| Location | 3203 S Cherokee Ln, Woodstock, Georgia |
| Authorized Official Name and Position | Magdy W Rezk (OWNER/ PHYSICIAN) |
| Authorized Official Contact | 7706756025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Weatherstone Medical Care Llc. 3203 S Cherokee Ln Suite 220 Woodstock GA 30188-4461 Ph: (770) 675-6025 | Weatherstone Medical Care Llc. 3203 S Cherokee Ln Suite 220 Woodstock GA 30188-4461 Ph: (770) 675-6025 |
| NPI Number | 1386997765 |
|---|---|
| Provider Enumeration Date | 10/22/2012 |
| Last Update Date | 10/22/2012 |
| Medicare PECOS PAC ID | 2365693652 |
|---|---|
| Medicare Enrollment ID | O20121114000384 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386997765 | NPI | - | NPPES |
| 186997325C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 053936 (Georgia) | Primary |
| Provider Name | Magdy W Rezk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053318808 PECOS PAC ID: 8729975529 Enrollment ID: I20040304000251 |
| Provider Name | Srividya Koduru |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073804969 PECOS PAC ID: 0648589911 Enrollment ID: I20151028000237 |
| Provider Name | Ravindranath Nallamothu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679724033 PECOS PAC ID: 4880864073 Enrollment ID: I20250221003177 |
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