NOUVEAU MEDIC LLC NPI 1104100395

NPI Information

NPI: 1104100395
Provider Name: NOUVEAU MEDIC LLC
Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
600 PHIPPS BLVD NE APT 1304
ATLANTA, GA
ZIP 30326
Phone: (678) 653-0045
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NOUVEAU MEDIC LLC is a multi-specialty clinic center in Atlanta, GA. NOUVEAU MEDIC LLC NPI is 1104100395. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

600 PHIPPS BLVD NE APT 1304
ATLANTA, GA
ZIP 30326-342
Phone: (678) 653-0045
Fax: (404) 393-3640

The provider's authorized official is Joy S Edwards .
The authorized official title is Clinical Manager and has the following contact phone number (678) 653-0045.

The enumeration date for this NPI number is 10/5/2011 and was last updated on 2/1/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0000X	Family Medicine	Adolescent Medicine	051126	GEORGIA	No
2	207QA0505X	Family Medicine	Adult Medicine	051126	GEORGIA	No
3	207RI0001X	Internal Medicine	Clinical & Laboratory Immunology			No
4	261QM1300X	Clinic/Center	Multi-Specialty			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NA	OTHER	GEORGIA	NA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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