| West Georgia Infectious Diseases | |
|
1700 Hospital South Dr Suite 402 Austell GA 30106 | |
| (770) 739-8282 | |
| (770) 739-0794 |
| Full Name | West Georgia Infectious Diseases |
|---|---|
| Speciality | Internal Medicine |
| Location | 1700 Hospital South Dr, Austell, Georgia |
| Authorized Official Name and Position | Kathryn Marie Shiver (OFFICE MANAGER) |
| Authorized Official Contact | 7707398282 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| West Georgia Infectious Diseases 1700 Hospital South Dr Suite 402 Austell GA 30106 Ph: (770) 739-8282 | West Georgia Infectious Diseases 1700 Hospital South Dr Suite 402 Austell GA 30106 Ph: (770) 739-8282 |
| NPI Number | 1881768117 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 07/17/2014 |
| Medicare PECOS PAC ID | 0244228559 |
|---|---|
| Medicare Enrollment ID | O20040505000334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881768117 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | () | Primary |
| Provider Name | Joseph Anthony Havlik |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1144325432 PECOS PAC ID: 0547455511 Enrollment ID: I20101117000006 |
| Provider Name | Mir Abid Husain |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235234527 PECOS PAC ID: 1456546423 Enrollment ID: I20101117000010 |
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