Provider Demographics
NPI:1790362994
Name:MD PSYCHIATRY CLINIC LLC
Entity Type:Organization
Organization Name:MD PSYCHIATRY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ZEHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ERDEVE TEMIZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-387-0303
Mailing Address - Street 1:210 DODD LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-3973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 NORTH POINT E
Practice Address - Street 2:SUITE 400
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:470-387-0303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1912326034OtherNPI