Provider Demographics
NPI:1659760718
Name:AMERICAN MEDICAL TESTING LAB AND TREATMENT CTR.
Entity Type:Organization
Organization Name:AMERICAN MEDICAL TESTING LAB AND TREATMENT CTR.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-831-9788
Mailing Address - Street 1:821 DAWSONVILLE HWY
Mailing Address - Street 2:BLDG 250 STE 101
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501
Mailing Address - Country:US
Mailing Address - Phone:617-410-9266
Mailing Address - Fax:866-468-3147
Practice Address - Street 1:6250 SHILOH RD
Practice Address - Street 2:STE 120
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8400
Practice Address - Country:US
Practice Address - Phone:617-410-9266
Practice Address - Fax:866-468-3147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty