Provider Demographics
NPI:1679137657
Name:INTERNAL MEDICINE CONSULTING SERVICES
Entity type:Organization
Organization Name:INTERNAL MEDICINE CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-500-8593
Mailing Address - Street 1:3365 PIEDMONT RD NE STE 1400
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1795
Mailing Address - Country:US
Mailing Address - Phone:404-500-8593
Mailing Address - Fax:984-207-5029
Practice Address - Street 1:3365 PIEDMONT RD NE STE 1400
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1795
Practice Address - Country:US
Practice Address - Phone:404-500-8593
Practice Address - Fax:984-207-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty