360 Medical Management

NPI 1013161637 - Specialist - 174400000X

NPI Details
NPI 1013161637
Enumeration Date 11/10/2008
Last Updated 05/01/2009
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name MYRON MYRON
Position MANAGING MEMBER
Phone (770) 591-8360
Fax (770) 591-8364
Practice Location
200 PARKBROOKE DR
SUITE 200
WOODSTOCK GA, 30189-6331, US
Phone (770) 591-8360
Fax (770) 591-8364
Business Location
200 PARKBROOKE DR
SUITE 100
WOODSTOCK GA, 30189-6331, US
Phone (770) 591-8360
Fax (770) 591-8364
Toxanomy
Taxonomy Code 174400000X
License State Georgia
License Number 058478
Remove 1013161637 NPI Number
 

According to our database, 360 Medical Management NPI is 1013161637, taxonomy code is 174400000X and license number is 058478, license state is located at Georgia. 360 Medical Management physically located at 200 Parkbrooke Dr, Woodstock GA, 30189-6331. NPI Number 1033115704 has the healthcare provider type.

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1013161637 NPI number is provided on an as is basis without warranty of any kind. 1013161637 is maintained by the National Plan & Provider Enumeration System. The contents of 360 Medical Management are for informational purposes only.