Provider Demographics
NPI:1003528860
Name:AVC MEDICAL LLC
Entity Type:Organization
Organization Name:AVC MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-777-1728
Mailing Address - Street 1:3 ASCOT MNR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-4201
Mailing Address - Country:US
Mailing Address - Phone:404-441-8545
Mailing Address - Fax:
Practice Address - Street 1:1455 LINCOLN PKWY E STE 315
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2209
Practice Address - Country:US
Practice Address - Phone:404-777-1728
Practice Address - Fax:404-777-1729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Multi-Specialty