ANTHONY JOHN POTHOULAKIS (NPI# 1548269012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548269012 |
| Entity Type | Individual |
| Full Name | ANTHONY JOHN POTHOULAKIS |
| Credential | MD |
| Practice Address |
475 Philip Blvd Ste 100 Lawrenceville GA 30046-8736 |
| Practice Telephone | 7709953300 |
| Practice Fax Number | 7709953307 |
| Mailing Telephone | 7709953300 |
| Mailing Fax Number | 7709953307 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2014-12-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
072758 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003151345 | 05 |
| Street Address |
475 PHILIP BLVD STE 100 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30046-8736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952809774 | Takatso Moyo | Nurse Practitioner | 475 Philip Blvd Ste 100, Lawrenceville, GA 30046-8736 | 2018-01-26 |
| 1457892770 | Rachel Pocock Shah | Internal Medicine | 475 Philip Blvd Ste 100, Lawrenceville, GA 30046-8736 | 2017-03-20 |
| 1881048973 | Sook Hyun Lee | Nurse Practitioner | 475 Philip Blvd Ste 100, Lawrenceville, GA 30046-8736 | 2016-04-15 |
| 1386015956 | Megan Narey | Nurse Practitioner | 475 Philip Blvd Ste 100, Lawrenceville, GA 30046-8736 | 2015-10-08 |
| 1467838334 | Angela Dawn Meeks | Nurse Practitioner | 475 Philip Blvd Ste 100, Lawrenceville, GA 30046-8736 | 2015-08-03 |
| 1063511749 | Nishith Oza | Physical Therapist | 475 Philip Blvd Ste 100, Credentialing Dept, Lawrenceville, GA 30046-8736 | 2006-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063023174 | Alpha & Omega Hearing Centers | Hearing Instrument Specialist | Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 | 2020-08-12 |
| 1285259846 | Mesun Health Services, Inc | Clinical Nurse Specialist | 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 | 2020-06-10 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1548730179 | Alexis Nicole Robinson | Nurse Anesthetist, Certified Registered | 1000 Medical Center Boulevard, Lawrenceville, GA 30046 | 2018-11-27 |
| 1679060388 | Christopher Puckett | Student in an Organized Health Care Education/Training Program | 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 | 2018-04-18 |
| 1457851255 | Advanced Urology Institute of Georgia | Urology | 501 Crown Point Way, Lawrenceville, GA 30046 | 2018-02-19 |
| 1013447044 | Pharmacy Investments of Lawrenceville, LLC | Pharmacy | 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 | 2017-06-13 |
| 1225577000 | Priority Housecalls LLC | Clinic/Center | 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 | 2017-02-14 |
| Find all providers in zip 30046 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1083269146 | Helio Malinverni Md Pa | Internal Medicine | 100 Federal City Rd Ste C-103, Lawrenceville, NJ 08648-1664 | 2019-08-06 |
| 1952698664 | Paul H Chew | Internal Medicine | 1 Brookdale Dr, Lawrenceville, NJ 08648-5545 | 2011-07-01 |
| 1821247156 | Mohammad Shafiq Choudhry | Internal Medicine | 1737 Princeton Ave, Lawrenceville, NJ 08648-4515 | 2008-09-10 |
| 1447434469 | Samir Suresh Shah | Internal Medicine | 3140 Princeton Pike Fl 2, Lawrenceville, NJ 08648-2330 | 2007-12-27 |
| 1841404233 | Jim Mathew John | Internal Medicine | 755 Walther Rd # 325-0159, Lawrenceville, GA 30046 | 2007-05-09 |
| 1356358741 | Henry A Liberman | Internal Medicine | 721 Wellness Way Ste 210, Lawrenceville, GA 30046-3304 | 2006-08-01 |
| 1376531517 | William Edward Costanzo | Internal Medicine | 3140 Princeton Pike, 2nd Floor, Lawrenceville, NJ 08648-2306 | 2005-10-12 |
| 1043206477 | Michael A. Lipsitt | Internal Medicine | 766 Walther Rd, Suite 100, Lawrenceville, GA 30046-8764 | 2005-09-21 |
| 1285620625 | Sheila Edith Hunter Woodhouse | Internal Medicine | 771 Old Norcross Rd Ste 105, Lawrenceville, GA 30046-4977 | 2005-09-21 |
| 1578563953 | Khalid Jalil Hayat | Internal Medicine | 755 Walther Rd, Lawrenceville, GA 30046 | 2005-07-27 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
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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.