Provider Demographics
NPI:1811300411
Name:1ST MD CARE, P.C.
Entity type:Organization
Organization Name:1ST MD CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:404-633-7433
Mailing Address - Street 1:1120 HOPE RD
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2957
Mailing Address - Country:US
Mailing Address - Phone:404-633-7433
Mailing Address - Fax:888-769-3558
Practice Address - Street 1:1120 HOPE RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-2957
Practice Address - Country:US
Practice Address - Phone:404-633-7433
Practice Address - Fax:888-769-3558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty