Organization · Type 2 NPI
Nouveau Medic LLC
Multi-Specialty Clinic/Center · Atlanta, GA
NPI number
1104100395
Active
Practice location
600 Phipps Blvd NE Apt 1304
Atlanta, GA 30326-3342
Fax (404) 393-3640
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adolescent Medicine (Family Medicine) Physician | 207QA0000X | 051126 (GA) |
| Adult Medicine Physician | 207QA0505X | 051126 (GA) |
| Clinical & Laboratory Immunology (Internal Medicine) Physician | 207RI0001X | None listed |
| Multi-Specialty Clinic/Center Primary | 261QM1300X | None listed |
Multi-Specialty Clinic/Center: Definition to come...
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About NPI 1104100395
Nouveau Medic LLC's National Provider Identifier is 1104100395, issued on Oct 5, 2011. The primary taxonomy on file is Multi-Specialty Clinic/Center (261QM1300X), and the practice location is in Atlanta, GA. The record was last updated on Feb 1, 2022.