Provider Demographics
NPI:1518720689
Name:MRSMD LLC
Entity Type:Organization
Organization Name:MRSMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:PURSELLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-931-7961
Mailing Address - Street 1:652 BELLEMEADE AVE NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-3102
Mailing Address - Country:US
Mailing Address - Phone:470-846-7763
Mailing Address - Fax:
Practice Address - Street 1:652 BELLEMEADE AVE NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-3102
Practice Address - Country:US
Practice Address - Phone:470-846-7763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty