National Provider Identifier Database

ILLUMINATE MEDICAL LLC
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

ILLUMINATE MEDICAL LLC
5257 BOWMAN SPRINGS TRL
FLOWERY BRANCH, GA30542-5193
Phone: 470-846-3790
Fax:
Website:
Specialty Taxonomy Code
* General Practice 208D00000X

* Indicates primary specialty

NPI Profile & details for ILLUMINATE MEDICAL LLC

NPI Number 1831928126
Legal business name
LBN
ILLUMINATE MEDICAL LLC
Authorized official SETH ILLU - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/26/2024
Last updated 07/26/2024 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

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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