NPI 1003146143

Innovative Medical, INC.

Organisation Family Medicine Physician Suwanee, GA

Practice location

Address: 1300 Peachtree Industrial Blvd Suite 2203, Suwanee, GA 30024-4539
Phone: (770) 988-2779
Fax: (678) 730-0229

Authorised official

Name: Connie Y Jeon
Title: Clinic Director
Phone: (770) 988-2779

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 058168 (GA)

Other Family Medicine providers in Georgia →

Registry record

NPI: 1003146143
Entity type: Organization
NPI issued: 13 Jan 2010
Record last updated: 13 Jan 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.