MAXA INTERNAL MEDICINE ASSOCIATES PC (NPI# 1902957152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902957152 |
| Entity Type | Organization |
| Organization Name | MAXA INTERNAL MEDICINE ASSOCIATES PC |
| Practice Address |
3505 Duluth Park Ln Building 4, Ste 400 Duluth GA 30096-3201 |
| Practice Telephone | 6785973180 |
| Practice Fax Number | 6785973181 |
| Mailing Telephone | 6785973180 |
| Mailing Fax Number | 6785973181 |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2011-07-19 |
| Authorized Official Name | ASHLEIGH MAXA (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 6785973180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
3505 DULUTH PARK LN BUILDING 4, STE 400 |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487645032 | Benigno B Bobon | Internal Medicine | 3505 Duluth Park Ln, Building 4, Ste 400, Duluth, GA 30096-3201 | 2005-11-02 |
| 1518367473 | Joel Kent Phillips | Physician Assistant | 3505 Duluth Park Ln, Suite 400, Duluth, GA 30096-3201 | 2014-08-28 |
| 1144371386 | Richard Reid Maxa | Internal Medicine | 3505 Duluth Park Ln, Building 4, Ste 400, Duluth, GA 30096-3201 | 2007-01-15 |
| 1235182767 | Tender Loving Care Health Care Services of Georgia, LLC | Home Health | 3505 Duluth Park Ln, Suite 300, Duluth, GA 30096-3201 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568013969 | Careatc | Clinic/Center | 2250 Satellite Blvd Ste 14, Duluth, GA 30097-4906 | 2019-09-26 |
| 1659768703 | Duluth Medical Center | Clinic/Center | 8 N 2nd Ave E Ste 304, Duluth, MN 55802-2121 | 2015-04-15 |
| 1902440159 | Hp Internal Medicine | Clinic/Center | 3635 Peachtree Industrial Blvd Ste 550, Duluth, GA 30096-2806 | 2019-10-31 |
| 1023562444 | Careatc - Quiktrip Duluth | Clinic/Center | 2250 Satellite Blvd, Suite 140, Duluth, GA 30097-4906 | 2016-08-15 |
| 1568832277 | Lake Superior Community Health Center | Clinic/Center | 4325 Grand Ave, Duluth, MN 55807-2730 | 2015-10-07 |
| 1639567472 | Atlanta Internal Medicine PC | Clinic/Center | 2400 Pleasant Hill Rd, Suite 300, Duluth, GA 30096-4396 | 2015-01-02 |
| 1194088906 | Snuppy, Inc. | Clinic/Center | 3473 Satellite Blvd, Ste 108 N, Duluth, GA 30096-8690 | 2012-06-18 |
| 1497926083 | C.a.r.e. Pediatrics, LLC | Clinic/Center | 4855 River Green Pkwy, Suite 610, Duluth, GA 30096-8336 | 2008-03-21 |
| 1548446545 | Naturally Chiropractic, P.a. | Clinic/Center | 404 W Superior St, Suite 225c, Duluth, MN 55802-1559 | 2008-01-21 |
| 1790861995 | Positive Impact Health Centers Inc | Clinic/Center | 3350 Breckinridge Blvd Ste 200, Duluth, GA 30096 | 2006-10-31 |
| Find all providers in DULUTH | ||||
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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.