Provider Demographics
NPI:1013523802
Name:COVIDCAREGA
Entity Type:Organization
Organization Name:COVIDCAREGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SOFIA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-567-6944
Mailing Address - Street 1:2150 PEACHFORD RD STE T
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6539
Mailing Address - Country:US
Mailing Address - Phone:404-567-6944
Mailing Address - Fax:404-796-7645
Practice Address - Street 1:2150 PEACHFORD RD STE T
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6539
Practice Address - Country:US
Practice Address - Phone:404-567-6944
Practice Address - Fax:404-796-7645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-17
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty