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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

NPI Number 1356526305
LBN Legal business name HERITAGE MEDICAL GROUP, PC
Authorized official OLADAYO OSINUGA - (MEDICAL DIRECTOR/OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 01/08/2008
Last updated 03/07/2023 - About 3 years ago
Identifiers
GA License # 057161
GA License # 51703
GA License # RN178172NP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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