Provider Demographics
NPI:1376952069
Name:NEESAM COMPANY INCORPORATED
Entity Type:Organization
Organization Name:NEESAM COMPANY INCORPORATED
Other - Org Name:SOUTH ATLANTA AREA PRIMARY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DREW
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-409-6577
Mailing Address - Street 1:777 CLEVELAND AVE SW STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-7115
Mailing Address - Country:US
Mailing Address - Phone:404-755-2291
Mailing Address - Fax:404-755-5377
Practice Address - Street 1:777 CLEVELAND AVE SW STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-7115
Practice Address - Country:US
Practice Address - Phone:404-755-2291
Practice Address - Fax:404-755-5377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003188149AMedicaid