Provider Demographics
NPI:1881666725
Name:NORTH GEORGIA FAMILY MEDICINE, P.C.
Entity Type:Organization
Organization Name:NORTH GEORGIA FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CACERES-CANTU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-867-9689
Mailing Address - Street 1:4895 WINDWARD PKWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-3850
Mailing Address - Country:US
Mailing Address - Phone:678-867-9689
Mailing Address - Fax:
Practice Address - Street 1:4895 WINDWARD PKWY
Practice Address - Street 2:SUITE 202
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-3850
Practice Address - Country:US
Practice Address - Phone:678-867-9689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA49485207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH63631Medicare UPIN