SAM PENG MD PC (NPI# 1043442080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043442080 |
| Entity Type | Organization |
| Organization Name | SAM PENG MD PC |
| Practice Address |
1622 Rivergreen Bnd Se Atlanta GA 30339-8546 |
| Practice Telephone | 7705875485 |
| Mailing Telephone | 7705875485 |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-08-10 |
| Authorized Official Name | SAM Q PENG (DIRECTOR) |
| Authorized Official Telephone | 7708203855 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
057232 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1622 RIVERGREEN BND SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30339-8546 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891303426 | Cheryl E Williams | Counselor | 1870 The Exchange, Suite 200 - 361, Atlanta, GA 30339 | 2020-07-20 |
| 1245854371 | Synergia Integrated Telebehavioral Health | Clinic/Center | 3941 Old Atlanta Station Drive, Southeast, Atlanta, GA 30339 | 2020-06-04 |
| 1972123883 | Elizabeth Newton, Psyd and Assoc Inc | Psychologist | 1827 Powers Ferry Rd, Bldg 21, Atlanta, GA 30339 | 2020-04-21 |
| 1881165207 | Le Reve Medical Clinic PC | Family Medicine | 1827 Powers Ferryy Rd Se Bldg 7, Suite 150, Atlanta, GA 30339 | 2018-12-11 |
| 1013499821 | Deonna Pennamon | Specialist/Technologist | 5625 Suffex Green Lane, Atlanta, GA 30339 | 2018-08-29 |
| 1205326915 | Matthew Buyert | Counselor | 1827 Powers Ferry Rd Se Ste 22, Atlanta, GA 30339 | 2018-05-17 |
| 1760991632 | Horizons Unlimited Professional Services Inc. | Community/Behavioral Health | 1755 The Exchange Se Ste 190, Atlanta, GA 30339 | 2017-09-23 |
| 1932624418 | Kheder Basheer | Student in an Organized Health Care Education/Training Program | 3224 Post Woods Dr., Apt E, Atlanta, GA 30339 | 2017-08-07 |
| 1417486820 | Ashley Drake | Counselor | 4695 N Church Ln Se Apt 10306, Atlanta, GA 30339 | 2017-06-08 |
| 1992248298 | New Legacy Counseling and Training Center | Point of Service | 3350 Riverwood Parkway, Suite 1925, Atlanta, GA 30339 | 2016-11-18 |
| Find all providers in zip 30339 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649690967 | Emily Nance Mason | Family Medicine | 35 Collier Rd Nw Ste 635, Atlanta, GA 30309-1611 | 2014-04-25 |
| 1427268101 | Sahebi A Saiyed | Family Medicine | 1841 Clifton Rd Ne, Atlanta, GA 30329-4021 | 2007-05-23 |
| 1376767483 | Melissa Phillips Black | Family Medicine | 1365 Clifton Rd Ne, Atlanta, GA 30322-1013 | 2007-04-12 |
| 1033241666 | Friendship Community Healthcare Inc | Family Medicine | 430 Centennial Olympic Park Dr Nw, Atlanta, GA 30313-2203 | 2007-03-09 |
| 1598860595 | Monica Willis Parker | Family Medicine | 12 Executive Park Dr Ne, Atlanta, GA 30329-2206 | 2006-09-14 |
| 1558476937 | Carole S Gardner | Family Medicine | 3495 Piedmont Road Ne, Medical Offices Administration, Atlanta, GA 30305 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295366292 | B Mata LLC | Family Medicine | 1631 Atlanta Hwy, Gainesville, GA 30504-5942 | 2020-01-28 |
| 1558916056 | Newtown Park Medical Clinic and Geriatrics LLC | Family Medicine | 2880 Old Alabama Rd #300, Johns Creek, GA 30022-5033 | 2019-08-02 |
| 1558830919 | Patriot Healthcare of Georgia, LLC | Family Medicine | 833 Hairston Road, Stone Mountain, GA 30083 | 2018-11-15 |
| 1275002636 | Patriot Healthcare of Georgia, LLC | Family Medicine | 1587 Phoenix Boulevard, Suite 6, College Park, GA 30349 | 2018-11-15 |
| 1215471479 | Deana Perkins | Family Medicine | 756 Arrowhead Lake Rd, Thomaston, GA 30286-5004 | 2016-12-07 |
| 1255731741 | Jafar Tabatabai M.d. P.C. | Family Medicine | 7961 Highway 92 Ste 100, Woodstock, GA 30189-5209 | 2014-09-03 |
| 1457604381 | Senior Care Plus Limited Liability Company | Family Medicine | 990 Peachtree Industrial Blvd Number 4532, Suwanee, GA 30024-5249 | 2012-10-16 |
| 1053662296 | Community Primary Care of Georgia LLC | Family Medicine | 946 Veterans Pkwy, Barnesville, GA 30204-3771 | 2012-09-27 |
| 1669770954 | J&a Wood, LLC | Family Medicine | 2724 Grey Fox Ct, Haddock, GA 31033-6009 | 2011-03-10 |
| 1134259369 | Rina Eisenstein | Family Medicine | 215 Arbor Creek Way, Roswell, GA 30076-1291 | 2007-03-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.