Provider Demographics
NPI:1821687393
Name:CADUCEUS TELEMED, LLC
Entity Type:Organization
Organization Name:CADUCEUS TELEMED, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TELEMEDICINE BILLING COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:KEDRA
Authorized Official - Middle Name:TANJUANA
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-761-1263
Mailing Address - Street 1:535 N CENTRAL AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:HAPEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30354-1603
Mailing Address - Country:US
Mailing Address - Phone:404-761-1263
Mailing Address - Fax:404-761-5036
Practice Address - Street 1:535 N CENTRAL AVE STE 206
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1603
Practice Address - Country:US
Practice Address - Phone:404-761-1263
Practice Address - Fax:404-761-5036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine