MR. ANTHONY E. MEDINA NPI 1174779177

NPI Information

NPI: 1174779177
Provider Name: MR. ANTHONY E. MEDINA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
2696 LAWRENCEVILLE SUWANEE RD
SUWANEE, GA
ZIP 30024
Phone: (678) 376-1300
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MR. Anthony E. Medina is a medical physician assistant in Suwanee, GA. MR. Anthony E. Medina NPI is 1174779177. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2696 LAWRENCEVILLE SUWANEE RD
SUWANEE, GA
ZIP 30024-535
Phone: (678) 376-1300
Fax: (678) 514-2936

The enumeration date for this NPI number is 8/11/2008 and was last updated on 5/18/2011.

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	101YM0800X	Counselor	Mental Health	RC60035704	WASHINGTON	No
2	363AM0700X	Physician Assistant	Medical	006030	GEORGIA	Yes

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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