Provider Demographics
NPI:1245319516
Name:MURIMI, JOHN N (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:MURIMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4550 COBB PARKWAY NW
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-4001
Mailing Address - Country:US
Mailing Address - Phone:770-974-4655
Mailing Address - Fax:770-974-1970
Practice Address - Street 1:4900 IVEY RD NW
Practice Address - Street 2:SUITE 1301
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-4001
Practice Address - Country:US
Practice Address - Phone:770-974-4655
Practice Address - Fax:770-974-1970
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-09-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA58373207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA111887OtherUGS-REIDSVILLE
GA111830OtherUGS-SWAINSBORO
GA111889OtherUGS-SOPERTON
GA08CBCNLMedicare ID - Type Unspecified
GAI72201Medicare UPIN