Provider Demographics
NPI:1124211883
Name:PERIMETER INTERNAL MEDICINE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PERIMETER INTERNAL MEDICINE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-256-5111
Mailing Address - Street 1:5667 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:SUITE 385
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1725
Mailing Address - Country:US
Mailing Address - Phone:404-256-5111
Mailing Address - Fax:404-252-3870
Practice Address - Street 1:5667 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 385
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1725
Practice Address - Country:US
Practice Address - Phone:404-256-5111
Practice Address - Fax:404-252-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASBL013931207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty