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Southside Internal Medicine Pc
Primary Care Clinic/Center in Riverdale, Georgia
NPI 1740583194

Southside Internal Medicine Pc is a Primary Care Clinic/Center based in Riverdale, GA and is specialized in Primary Care. Southside Internal Medicine Pc practices in Riverdale, GA. The NPI Number for Southside Internal Medicine Pc is 1740583194 and holds a License No. (Georgia).

The current practice location address for Southside Internal Medicine Pc is 804 Commerce Blvd, Riverdale, GA and can be reached out via phone at 770-997-6644 and via fax at 770-997-6630.

Location: 804 Commerce Blvd, Riverdale, GA, 30274-3453
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1740583194
Provider Name
Southside Internal Medicine Pc
Credential
Provider Entity Type
Organization
Address
804 Commerce Blvd, Riverdale, GA, 30274-3453
Phone Number
770-997-6644
Fax Number
770-997-6630
Provider Enumeration Date
12/07/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000544948J 05 GA
institution
Provider Business Practice Location Address Details
Address
804 Commerce Blvd
City
Riverdale
State
Georgia
Zip
30296-7198
Phone Number
770-997-6644
Fax Number
770-997-6630
person
Provider Business Mailing Address Details
Address
804 Commerce Blvd
City
Riverdale
State
Georgia
Zip
30296-7198
Phone Number
770-997-6644
Fax Number
770-997-6630
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
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Definition
Definition to come...
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