Cumming Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

011753 Issued in GA

Legal business name

CUMMING FAMILY PRACTICE

Practice address

319 Canton Rd
Cumming, GA 30040-2213

Phone

(770) 886-8152

Fax

(770) 886-8153

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Manuel M Fajardo, M.D.

Title

Owner

Phone

(770) 886-8152

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104972298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402213",
            "telephone_number": "770-886-8152",
            "fax_number": "770-886-8153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 CANTON RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300402213",
            "telephone_number": "770-886-8152",
            "fax_number": "770-886-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMMING FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAJARDO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-886-8152",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "011753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Cumming, GA
• Providers in Cumming, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.