EDWARD C. MACK (NPI# 1245338110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245338110 |
| Entity Type | Individual |
| Full Name | EDWARD C. MACK |
| Credential | M.D. |
| Practice Address |
315 Boulevard Ne Suite 444 Atlanta GA 30312-1200 |
| Mailing Address |
P.o. Box 370569 Decatur GA 30037 |
| Practice Telephone | 4044200116 |
| Practice Fax Number | 4044200117 |
| Mailing Telephone | 6784925985 |
| Mailing Fax Number | 4044200117 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2011-09-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 021754 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000203002D | 05 | |
| GA | AETNA PROVIDER NUMBER | 5729084 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457485492 | Edward Maurice Mack | Dentist | 5180 Park Ave, Suite 300, Memphis, TN 38119-3521 | 2007-03-14 |
| 1134148836 | Edward J Mack | Internal Medicine | 79 Middleville Road, Chief of Staff Office(11), Northport, NY 11768 | 2006-07-19 |
| Street Address |
315 BOULEVARD NE SUITE 444 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30312-1200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609874023 | Courtney D Shelton | Family Medicine | 315 Boulevard Ne, Suite 310, Atlanta, GA 30312-1200 | 2005-07-10 |
| 1205316395 | Yolette Lafontant | Nurse Practitioner | 315 Boulevard Ne, Atlanta, GA 30312-1200 | 2018-08-17 |
| 1659871994 | Traci Ann Robinson | Nurse Practitioner | 315 Boulevard Ne, Atlanta, GA 30312-1200 | 2018-02-13 |
| 1982155222 | Terescah Lemon | Counselor | 315 Boulevard Ne, Atlanta, GA 30312-1200 | 2016-10-21 |
| 1154785624 | Shelton Hospitalists Group, LLC | Internal Medicine | 315 Boulevard Ne, Suite 310, Atlanta, GA 30312-1264 | 2016-04-11 |
| 1720471261 | Pacific Coast Medical Group Company | Preventive Medicine | 315 Boulevard Ne, Suite 555, Atlanta, GA 30312-1200 | 2015-03-09 |
| 1447690581 | Lynn Lipa | Registered Nurse | 315 Boulevard Ne, Suite 332, Atlanta, GA 30312-1200 | 2013-07-03 |
| 1558637512 | Althea L. Turk,m.d.,p.c. | Ophthalmology | 315 Boulevard Ne, Suite 242, Atlanta, GA 30312-1200 | 2012-03-23 |
| 1144518291 | Veena Malepati | Internal Medicine | 315 Boulevard Ne, Atlanta Medical Center, Atlanta, GA 30312-1200 | 2011-07-11 |
| 1306131396 | Lonnie C. Jenkins Md PC | Internal Medicine | 315 Boulevard Ne, Suite 516, Atlanta, GA 30312 | 2011-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770108516 | Bita Ranjbari | Physician Assistant | 659 Auburn Ave Se, Suite 505, Atlanta, GA 30312 | 2020-06-08 |
| 1609439629 | Adeyinka Edward Adeniyi | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center, 303 Parkway Drive Ne, 4th Floor, Internal Medicine Department, Atlanta, GA 30312 | 2019-04-16 |
| 1003378670 | James Spratt IIi | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Ne, 4th Floor, Wellstar Atlanta Medical Center Department of Orthopaed, Atlanta, GA 30312 | 2019-04-03 |
| 1659833440 | Derrick Edward Wendler | Student in an Organized Health Care Education/Training Program | Wellstar Atlanta Medical Center Dpt of Orthopaedics, 303 Parkway Drive Ne, 4th Floor, Atlanta, GA 30312 | 2019-04-02 |
| 1336631266 | The Atlanta Small Business Training Consortium, Inc. | Local Education Agency (LEA) | 250 Georgia Ave Se Ste 207a, Atlanta, GA 30312 | 2018-06-06 |
| 1669960134 | Derek Mccranie | Student in an Organized Health Care Education/Training Program | 303 Parkway Drive, Atlanta, FL 30312 | 2018-04-30 |
| 1336646223 | Amy Ruth Williams | Nurse Practitioner | 383 Ralph Mcgill Blvd Ne Apt D, Atlanta, GA 30312 | 2018-04-09 |
| 1730689183 | Lisa Marie Margavage | Chiropractor | 720 Ralph Mcgill Blvd Ne Unit 210, Atlanta, GA 30312 | 2018-02-12 |
| 1922518836 | Rodney Aldridge | Registered Nurse | 250 Georgia Avenue, Suite 206, Atlanta, GA 30312 | 2017-10-05 |
| 1629599279 | Huda Hashim Elsamani Elsheikh | Student in an Organized Health Care Education/Training Program | 303 Parkway Dr Ne, Wellstar Atlanta Medical Center, Dept of Graduate Medical Education, Internal Medicine, Atlanta, GA 30312 | 2017-07-05 |
| Find all providers in zip 30312 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407752 | Neighbormd of Atlanta LLC | Internal Medicine | 285 Boulevard Ne Ste 435&436, Atlanta, GA 30312-4205 | 2020-11-06 |
| 1053912907 | Neighbormd of North Atlanta LLC | Internal Medicine | 1800 Peachtree St Nw Ste 730nw, Atlanta, GA 30309-2519 | 2020-11-06 |
| 1285235036 | Neighbormd of South Atlanta LLC | Internal Medicine | 3885 Princeton Lakes Way Sw Ste 412, Atlanta, GA 30331-5599 | 2020-11-06 |
| 1679137657 | Internal Medicine Consulting Services | Internal Medicine | 3365 Piedmont Rd Ne Ste 1400, Atlanta, GA 30305-1795 | 2019-04-25 |
| 1144788142 | Jaytyn LLC | Internal Medicine | 4600 Broswell Road, Atlanta, GA 30342 | 2019-03-08 |
| 1326527144 | Vergena Montgomery Clark | Internal Medicine | 3142 Esplanade Cir Sw, Atlanta, GA 30311-4221 | 2018-08-13 |
| 1790299071 | Jay Leonard Lichtenfeld | Internal Medicine | 1711 E Clifton Rd Ne, Atlanta, GA 30307-1247 | 2017-11-26 |
| 1558872432 | Qcpi-villagemd, PC | Internal Medicine | 3445 Peachtree Rd Ne Ste 1200, Atlanta, GA 30326-3251 | 2017-10-18 |
| 1033640115 | Christopher Massad | Internal Medicine | 1364 Clifton Rd Ne Ste H-153, Atlanta, GA 30322-1059 | 2017-03-21 |
| 1114377025 | Atlanta Clinical Research Centers LLC | Internal Medicine | 5673 Peachtree Dunwoody Rd Ste 440, Atlanta, GA 30342-1797 | 2016-06-21 |
| Find all providers in ATLANTA | ||||
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| 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.