EASTSIDE INTERNAL MEDICINE, LLC (NPI# 1437211703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437211703 |
| Entity Type | Organization |
| Organization Name | EASTSIDE INTERNAL MEDICINE, LLC |
| Practice Address |
2080 Eastside Dr Suite A Conyers GA 30013-1953 |
| Practice Telephone | 6786257800 |
| Practice Fax Number | 6786257888 |
| Mailing Telephone | 6786257800 |
| Mailing Fax Number | 6786257888 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SYED WASIM (OWNER) |
| Authorized Official Telephone | 6786257800 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | NPI NUMBER | 1871551788 | 01 |
| GA | NPI NUMBER | 1992763809 | 01 |
| GA | NPI NUMBER | 1093773905 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932256526 | Eastside Internal Medicine, LLC | Legal Medicine | 2080 Eastside Dr, Suite A, Conyers, GA 30013-1953 | 2007-01-04 |
| Street Address |
2080 EASTSIDE DR SUITE A |
| City | CONYERS |
| State | GA |
| Zip Code | 30013-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932256526 | Eastside Internal Medicine, LLC | Legal Medicine | 2080 Eastside Dr, Suite A, Conyers, GA 30013-1953 | 2007-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842295 | Fit Therapy, LLC | Physical Therapist | 2008 Eastview Parkway, Suite 150, Conyers, GA 30013 | 2020-05-12 |
| 1144854753 | Atl Optical LLC | Optometrist | 1285 Ga 138, Conyers, GA 30013 | 2020-02-24 |
| 1386201820 | Achundris P Taylor | Social Worker | Harvest Grove Lane, Conyers, GA 30013 | 2019-05-21 |
| 1588153381 | Curbside Medical Transporters | Ambulance | 2404 Brynlyn Woods Dr Ne, Conyers, GA 30013 | 2018-05-07 |
| 1184124877 | Nursing Companion, LLC | Homemaker | 1064 Duke Dr, Conyers, GA 30013 | 2018-02-19 |
| 1588163638 | Atlanta Plus Urgent Care | Clinic/Center | 2121 Salem Rd. Se, Conyers, GA 30013 | 2018-02-05 |
| 1043735244 | Niki Tanyell Davis | Licensed Practical Nurse | 1403 Windy Hill Court, Conyers, GA 30013 | 2017-08-08 |
| 1063941490 | Comprehensive Health and Rehab LLC | Clinic/Center | 2500 Riverton Drive, Conyers, GA 30013 | 2017-06-08 |
| 1306373188 | Graceol Corporation | Family Medicine | 1035 Honey Creek Rd, Conyers, GA 30013 | 2017-05-11 |
| 1881149268 | Jsa Dental Associates Conyers PC | Dentist | 1151 Nor Tec Dr, Suite B, Conyers, GA 30013 | 2016-08-16 |
| Find all providers in zip 30013 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528358280 | Camille Patrice Mclean | Internal Medicine | 2347 New Haven Pl, Conyers, GA 30094-3358 | 2011-04-14 |
| 1508186867 | Craig O'neil Campbell | Internal Medicine | 1525 Paceville Ct, Conyers, GA 30012-7125 | 2010-06-09 |
| 1982832739 | Gregory E. Jones | Internal Medicine | 1415 Milstead Ave Ne, Conyers, GA 30012 | 2009-06-30 |
| 1982845665 | Samuel Davis Mintlow | Internal Medicine | 3241 Lindas Cir Se, Conyers, GA 30013-2238 | 2009-03-10 |
| 1689730244 | Bassam Tome | Internal Medicine | 1277 Wellbrook Cir Ne, Suite C, Conyers, GA 30012-3873 | 2006-12-28 |
| 1457446189 | Mary Harris Stephens | Internal Medicine | 1301 Wellbrook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1457446171 | James Ransford De Give | Internal Medicine | 1301 Well Brook Circle, Conyers, GA 30012-3873 | 2006-10-04 |
| 1215028253 | Harmon Andrew Smith | Internal Medicine | 1080 Green St Sw, Conyers, GA 30012-5269 | 2006-09-27 |
| 1386735066 | East Metro Internal Medicine | Internal Medicine | 3641 Highway 20 Se, Suite A, Conyers, GA 30013-3064 | 2006-09-27 |
| 1245345883 | Roopal Anil Desa | Internal Medicine | 3641 Hwy 20 Se, Suite A, Conyers, GA 30013 | 2006-08-21 |
| Find all providers in CONYERS | ||||
Please comment or provide details below to improve the information on EASTSIDE INTERNAL MEDICINE, LLC.
| 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.