Provider Demographics
NPI:1679640056
Name:APOLLO MEDICAL CARE, P.C.
Entity Type:Organization
Organization Name:APOLLO MEDICAL CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEEPA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGARAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-623-3056
Mailing Address - Street 1:6325 W JOHNS XING
Mailing Address - Street 2:BUILDING 1000, SUITE 301
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1530
Mailing Address - Country:US
Mailing Address - Phone:770-623-3056
Mailing Address - Fax:770-623-3057
Practice Address - Street 1:6325 W JOHNS XING
Practice Address - Street 2:BUILDING 1000, SUITE 301
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-1530
Practice Address - Country:US
Practice Address - Phone:770-623-3056
Practice Address - Fax:770-623-3057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty