Provider Demographics
NPI:1477822575
Name:ATLANTA INTERNAL MEDICINE GROUP, INC.
Entity Type:Organization
Organization Name:ATLANTA INTERNAL MEDICINE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHAMPION
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-361-0090
Mailing Address - Street 1:4930 GOVERNORS DR
Mailing Address - Street 2:SUITE 401
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-6101
Mailing Address - Country:US
Mailing Address - Phone:404-361-0090
Mailing Address - Fax:404-361-2564
Practice Address - Street 1:4930 GOVERNORS DR
Practice Address - Street 2:SUITE 401
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-6101
Practice Address - Country:US
Practice Address - Phone:404-361-0090
Practice Address - Fax:404-361-2564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty