Mack, Eniki A

Mack, Eniki A is an individual health care provider with primary practice located at 1240 Jesse Jewell Pkwy Se Suite 500, Gainesville GA 30501-3862. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Mack, Eniki A can be contacted via phone (770) 536-9864.

Contact Information

Primary practice address
1240 Jesse Jewell Pkwy Se Suite 500 Gainesville GA 30501-3862
Phone: (770) 536-9864
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 064410 Georgia

Profile Details

NPI number 1730307927
LBN Legal business name Mack, Eniki A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 23rd, 2007
Last updated Sep 14th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730307927 NPPES
Other 12099189 CAQH

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