METRO MEDICAL ASSOCIATES OF DECATUR, LLC (NPI# 1043526114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043526114 |
| Entity Type | Organization |
| Organization Name | METRO MEDICAL ASSOCIATES OF DECATUR, LLC |
| Practice Address |
1829 Lawrenceville Hwy Decatur GA 30033-5728 |
| Mailing Address |
11379 Southbridge Pkwy Suite A Alpharetta GA 30022-4402 |
| Practice Telephone | 4042928335 |
| Practice Fax Number | 6789042649 |
| Mailing Telephone | 7707770750 |
| Mailing Fax Number | 7707770521 |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2010-08-26 |
| Authorized Official Name | DHARMARAJ PATIL (MEMBER MANAGER) |
| Authorized Official Telephone | 6787770719 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 042386 | GA | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
054164 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1829 LAWRENCEVILLE HWY |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-5728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124013495 | Amina Hassanali | General Practice | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2005-09-13 |
| 1659883684 | Brantriesa Clark | Physician Assistant | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2017-10-31 |
| 1710333257 | Daniel Keith Ralston | Family Medicine | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2016-05-13 |
| 1992185573 | Smartcare, LLC | Clinic/Center | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2015-06-09 |
| 1851606834 | Atlanta Metro Cardiology | Internal Medicine | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2010-08-13 |
| 1700974805 | Abhay Trivedi | Internal Medicine | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2006-10-11 |
| 1942228788 | Madhava R Koti | Emergency Medicine | 1829 Lawrenceville Hwy, Decatur, GA 30033-5728 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821617036 | Matthew Charles Revilla | Family Medicine | 1670 Clairmont Rd, Decatur, GA 30033-4004 | 2020-04-09 |
| 1629586946 | Ashley Ferguson | Family Medicine | 330 N Wyckles Rd, Decatur, IL 62522-1034 | 2018-01-22 |
| 1538586995 | Dekalb Gpo LLC | Family Medicine | 2801 N Decatur Rd, Suite 200, Decatur, GA 30033-5949 | 2014-03-24 |
| 1033498118 | Syed Zia Ullah | Family Medicine | 2536 Lawrenceville Hwy, Decatur, GA 30033-3227 | 2011-08-08 |
| 1457473795 | Healing Innovations, P.C. | Family Medicine | 5040 Snapfinger Woods Dr, Suite 201, Decatur, GA 30035-4020 | 2007-04-06 |
| 1376665463 | Family Care Centers Trust | Family Medicine | 1045 Sycamore Dr, Adminstration, Decatur, GA 30030-1645 | 2007-04-06 |
| 1477672640 | Family Care Centers Trust | Family Medicine | 1045 Sycamore Dr, Decatur, GA 30030-1645 | 2007-03-28 |
| 1689737603 | Primary Medical Care Group | Family Medicine | 5322 Snapfinger Park Dr, Decatur, GA 30035-4040 | 2006-12-19 |
| 1942373089 | Song Yol Yu | Family Medicine | 319 W Delaware St, Decatur, MI 49045-1106 | 2006-11-16 |
| 1609880160 | Shainul K Bhatia | Family Medicine | 1045 Sycamore Dr, Decatur, GA 30030-1645 | 2006-07-28 |
| Find all providers in DECATUR | ||||
Please comment or provide details below to improve the information on METRO MEDICAL ASSOCIATES OF DECATUR, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.