NPI 1942845417

Royal Blue Medical Center Ga. INC

Organisation General Practice Physician Lawrenceville, GA

Practice location

Address: 555 Old Norcross Rd STE 100, Lawrenceville, GA 30046-8703
Phone: (704) 277-1750
Mailing address: 2023 Connonade Dr, Waxhaw, NC 28173-0109

Authorised official

Name: Omar Ellison
Title: Owner
Phone: (704) 277-1750

Registered specialties (4)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Georgia →

Sports Medicine (Physical Medicine & Rehabilitation) Physician

Allopathic & Osteopathic Physicians Taxonomy 2081S0010X

Other Physical Medicine & Rehabilitation providers in Georgia →

Sports Medicine (Preventive Medicine) Physician

Allopathic & Osteopathic Physicians Taxonomy 2083S0010X

Other Preventive Medicine providers in Georgia →

Pain Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QP3300X

Other Clinic/Center providers in Georgia →

Registry record

NPI: 1942845417
Entity type: Organization
NPI issued: 8 Nov 2019
Record last updated: 8 Sep 2020

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.