Gwinnett Multi Specialty Group LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

38545 Issued in GA

Legal business name

GWINNETT MULTI SPECIALTY GROUP LLC

Practice address

3840 Peachtree Industrial Boulevard
Duluth, GA 30096-4847

Phone

(770) 670-6565

Fax

(770) 670-6566

NPI assigned

Apr 7, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter K Lee, M.D

Title

Managing Partner

Phone

(770) 607-6565

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1003089418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 PEACHTREE INDUSTRIAL BOULEVARD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964847",
            "telephone_number": "770-670-6565",
            "fax_number": "770-670-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 PEACHTREE INDUSTRIAL BOULEVARD",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964847",
            "telephone_number": "770-670-6565",
            "fax_number": "770-670-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT MULTI SPECIALTY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "770-607-6565",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "38545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Duluth, GA
• Providers in Duluth, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.