NPI 1659494847

Premier Internal Medicine

Organisation Internal Medicine Physician Hiram, GA

Practice location

Address: 5604 Wendy Bagwell Pkwy STE 711, Hiram, GA 30141-7813
Phone: (678) 384-0800
Fax: (678) 384-0801
Mailing address: 5604 Wendybagwell Pkwy (hwy 278) Suite 711, Hiram, GA 30141-2291

Authorised official

Name: Richard J Breckwoldt
Title: Medical Director
Phone: (678) 384-0800

Registered specialties

Internal Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207R00000X Licence 039295 (GA)

Other Internal Medicine providers in Georgia →

Registry record

NPI: 1659494847
Entity type: Organization
NPI issued: 10 Apr 2007
Record last updated: 29 Sep 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.