Organization

Mcc Internal Medicine 2, Llc

Specialist in Macon, GA(View on Map)

Legal Business Name

Mcc Internal Medicine 2, Llc

NPI Number

1366899189

NPI Type

Organization

Enumeration Date

05/23/2016

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

66228

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 468329
6501 PEAKE RD

City

Atlanta
Macon

State

GA
GA

Postal Code

31146-8329
31210-8042

Country

US
US

Telephone Number

(770) 579-2626
(478) 273-2662

Authorized Official

Name

Mrs. Shelley Depp

Title or Position

PAYER RELATIONS LIAISON

Telephone Number

(770) 579-2626

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/23/2016

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