Provider Demographics
NPI:1376167171
Name:ATLANTIC PRIMARY CARE PLLC
Entity Type:Organization
Organization Name:ATLANTIC PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BATNIJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-872-5190
Mailing Address - Street 1:PO BOX 1092
Mailing Address - Street 2:
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06083-1092
Mailing Address - Country:US
Mailing Address - Phone:860-746-4112
Mailing Address - Fax:386-872-5193
Practice Address - Street 1:735 DUNLAWTON AVE STE B
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-9226
Practice Address - Country:US
Practice Address - Phone:386-872-5190
Practice Address - Fax:386-872-5193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty