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Contact Information

ILLUMINATE MEDICAL LLC
5257 BOWMAN SPRINGS TRL
FLOWERY BRANCH, GA30542-5193
 Phone: 470-846-3790
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for ILLUMINATE MEDICAL LLC · (Female)

NPI Number 1831928126
Status Active
Credentials
Entity Individual
Enumeration date 07/26/2024
Last updated 07/26/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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