Provider Demographics
NPI:1407626484
Name:VIRTUAL MED GROUP LLC
Entity Type:Organization
Organization Name:VIRTUAL MED GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:NIZAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIBHAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-488-8933
Mailing Address - Street 1:2951 FLOWERS RD S
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-5532
Mailing Address - Country:US
Mailing Address - Phone:404-488-8933
Mailing Address - Fax:
Practice Address - Street 1:2951 FLOWERS RD S
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-5532
Practice Address - Country:US
Practice Address - Phone:404-488-8933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care