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Contact Information

HERITAGE MEDICAL GROUP, PC
1010 PENNSYLVANIA AVENUE
HERITAGE MEDICAL GROUP, PC
MCDONOUGH, GA30253
 Phone: 770-288-3883
 Fax: 770-288-3885
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Adult Health

363LA2200X 50 Nurse Practitioner
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for HERITAGE MEDICAL GROUP PC · (Female)

NPI Number 1356526305
Status Active
Credentials
Entity Individual
Enumeration date 01/08/2008
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 057161
  • GA License # 51703
  • GA License # RN178172NP
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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