Grace Medical Practice Ltd

LBN: Grace Medical Practice Ltd
Grace Medical Practice Ltd is an health care organization with primary practice located at 1136 Cleveland Ave Ste 309 , East Point GA 30344-3618. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Grace Medical Practice Ltd can be contacted via phone (404) 763-1240, or through Osinubi, Fidelia O via phone (404) 861-0291.

Contact Information

Primary practice address
1136 Cleveland Ave Ste 309 East Point GA 30344-3618
Phone: (404) 763-1240
Fax: (404) 393-6524
Website:
Map and Directions
Authorized official contact:
Name: Osinubi, Fidelia O Doctor of Medicine (MD)
Phone: (404) 861-0291

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 001305 Georgia

Profile Details

NPI number 1396070744
LBN Legal business name Grace Medical Practice Ltd
DBA Doing business as
Authorized official Osinubi, Fidelia O Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2009
Last updated Oct 2nd, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396070744 NPPES
Georgia MEDICAID 778620923A
Georgia Other 06/11/1956

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