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NPI Profile for EAGLE DRIVE FAMILY MEDICINE PC in WOODSTOCK, GA.
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] |
| NPI # | 1750514295 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/01/2009 | |
| Last updated | 01/25/2012 - About 14 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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EAGLE DRIVE FAMILY MEDICINE PC
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EAGLE DRIVE FAMILY MEDICINE PC