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Contact Information

MOUNTAIN MEDICAL SPECIALISTS, PC
207 ADAMS DR
DEMOREST, GA30535-4501
 Phone: 706-754-5191
 Fax: 706-754-5191
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MOUNTAIN MEDICAL SPECIALISTS PC · (Female)

NPI Number 1366504789
Status Active
Credentials
Entity Individual
Enumeration date 12/14/2006
Last updated 03/07/2024 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 26375
  • GA License # RN124242
  • GA Medicaid 000300605D
  • GA Other 110104731 RAILROAD MEDICARE
  • GA Other D42109 SANDERS UPIN NUMBER
  • GA Other 194840 WELLCARE VENDOR NUMBER
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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