Provider Demographics
NPI:1841820917
Name:VEDIC FAMILY PRACTICE AND WELLNESS
Entity type:Organization
Organization Name:VEDIC FAMILY PRACTICE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:704-615-2367
Mailing Address - Street 1:1240 UPPER HEMBREE RD STE E
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0914
Mailing Address - Country:US
Mailing Address - Phone:404-255-5583
Mailing Address - Fax:404-255-5593
Practice Address - Street 1:1240 UPPER HEMBREE RD STE E
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-0914
Practice Address - Country:US
Practice Address - Phone:404-255-5583
Practice Address - Fax:404-255-5593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-17
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty