Provider Demographics
NPI:1851301907
Name:YOU, ALICE WEI (MD)
Entity Type:Individual
Prefix:
First Name:ALICE WEI
Middle Name:
Last Name:YOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WEI
Other - Middle Name:
Other - Last Name:YOU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5816 POPPY TREE HOLLOW
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084
Mailing Address - Country:US
Mailing Address - Phone:770-564-2397
Mailing Address - Fax:
Practice Address - Street 1:4855 RIVER GREEN PARKWAY
Practice Address - Street 2:SUITE 520
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096
Practice Address - Country:US
Practice Address - Phone:678-417-1588
Practice Address - Fax:678-417-1589
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 051195207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H58867Medicare UPIN
115CFGKMedicare ID - Type Unspecified