Wallace Duncan (NPI# 1821153529, PAC ID# 6002707601) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1821153529 |
| PAC ID by PECOS | 6002707601 |
| Professional Enrollment ID | I20040323000961 |
| Full Name | Wallace Duncan |
| Organization Legal Name | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| Address |
5910 Hillandale Dr Suite 355 Lithonia GA 30058-1880 |
| Phone Number | 7709878400 |
| Gender | M |
| Credential | MD |
| Medical School | MOREHOUSE SCHOOL OF MEDICINE |
| Graduation Year | 1992 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 4284951542 |
| Number of Group Practice Members | 215 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110226 | DEKALB MEDICAL CENTER AT HILLANDALE |
| Address | Phone | Organization |
|---|---|---|
| 5910 Hillandale Dr, Suite 355, Lithonia, GA 30058-1880 | 7709878400 | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| Organization Legal Name | PRIVIA MEDICAL GROUP OF GEORGIA LLC |
| Physicians | 225 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary Deason Perritt | Nurse Practitioner | Privia Medical Group of Georgia LLC | 1218 Alice St, Waycross, GA 31501-4525 |
| Angela Duke | Nurse Practitioner | Privia Medical Group of Georgia LLC | 106 Pilgrim Village Dr, Suite 400, Cumming, GA 30040-9242 |
| Daniel John Callahan | Physician Assistant | Privia Medical Group of Georgia LLC | 100 Genevieve Ct, Suite A, Peachtree City, GA 30269-4868 |
| Holly M Loesch | Obstetrics/gynecology | Privia Medical Group of Georgia LLC | 440 Washington St Se, Gainesville, GA 30501-3619 |
| Lyudmila P Carter | Internal Medicine | Privia Medical Group of Georgia LLC | 109 W Oglethorpe Hwy, Hinesville, GA 31313-3657 |
| Michaela Seward Jones | Nurse Practitioner | Privia Medical Group of Georgia LLC | 1010 E Fwy Dr Se, Conyers, GA 30094-5965 |
| Erin Wells Raser | Physician Assistant | Privia Medical Group of Georgia LLC | 4000 Shakerag Hl, Suite 301, Peachtree City, GA 30269-4047 |
| Morgan Charlotte Jackson | Nurse Practitioner | Privia Medical Group of Georgia LLC | 119 W Hill St, Thomasville, GA 31792-6618 |
| Ashley Paige Keen | Nurse Practitioner | Privia Medical Group of Georgia LLC | 2402 Osler Ct, Albany, GA 31707-0205 |
| Jeanette Dormio | Nurse Practitioner | Privia Medical Group of Georgia LLC | 1655 Lebanon Rd, Suite A, Lawrenceville, GA 30043-5116 |
| Street Address |
5910 HILLANDALE DR SUITE 355 |
| City | LITHONIA |
| State | GA |
| Zip | 30058-1880 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Yara Venita Robertson | General Surgery | Metro Surgical Associates, Inc | 5910 Hillandale Dr, Suite 104, Lithonia, GA 30058-1877 |
| Rogsbert F Phillips | General Surgery | Metro Surgical Associates, Inc | 5910 Hillandale Dr, Suite 104, Lithonia, GA 30058-1877 |
| Sherell Vicks | Internal Medicine | 5910 Hillandale Dr, Suite 202, Lithonia, GA 30058-1877 | |
| Alan R Friedman | General Surgery | Alan R Friedman, Md PC | 5910 Hillandale Dr, Lithonia, GA 30058-1878 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Berman | Emergency Medicine | Cep America LLC | 2801 Dekalb Pkwy, Lithonia, GA 30058 |
| Michelle K Carpenter | Certified Registered Nurse Anesthetist (crna) | Gastroenterology Anesthesia Associates, LLC | 5403 Hillandale Park Ct A, Lithonia, GA 30058 |
| John E Spaulding Jr. | Emergency Medicine | Cep America LLC | 2801 Dekalb Pkwy, Lithonia, GA 30058 |
| Marlon G Fisher | Emergency Medicine | Cep America LLC | 2801 Dekalb Pkwy, Lithonia, GA 30058 |
| Clifford R Seward | Ophthalmology | 5900 Hillandale Dr, Suite 345, Lithonia, GA 30058-3802 | |
| Lauren Elizabeth Mcdowell | Physical Therapy | Dekalb Comprehensive Physical Therapy Ltd Partnership | 2410 Dekalb Medical Pkwy, Suite E, Lithonia, GA 30058-4100 |
| Lawanna K Monday | Podiatry | Village Podiatry Group, LLC. | 5700 Hillandale Dr, Suite 290, Lithonia, GA 30058-4103 |
| Notoya Scott | Nurse Practitioner | Aids Healthcare Foundation | 5700 Hillandale Dr, Suite 100, Lithonia, GA 30058-4104 |
| John Phillip Ouderkirk | Internal Medicine | Aids Healthcare Foundation | 5700 Hillandale Dr, Suite 100, Lithonia, GA 30058-4104 |
| Timothy P Milner | Vascular Surgery | 5700 Hillandale Dr, Suite 120, Lithonia, GA 30058-4104 | |
| Find all physicians in zip 30058 | |||
| City | LITHONIA |
| Zip Code | 30058 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | LITHONIA + INTERNAL MEDICINE |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.