Dekalb Internal Medicine Associates, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

046623 Issued in GA

Legal business name

DEKALB INTERNAL MEDICINE ASSOCIATES, PC

Practice address

1980 Montreal Rd
Tucker, GA 30084-5217

Phone

(770) 270-4060

Fax

(770) 270-4061

NPI assigned

Oct 1, 2011

Last updated

Oct 1, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ali M Mohamed, MDNPI 1154448967

Title

Ceo

Phone

(770) 270-4060

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ali M Mohamed, MD

  • Internal Medicine Physician
  • Tucker, GA
  • NPI 1154448967
  NPD (past) Authorized official

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

{
    "created_epoch": "1317427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317427200000",
    "number": "1255615852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845217",
            "telephone_number": "770-270-4060",
            "fax_number": "770-270-4061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845217",
            "telephone_number": "770-270-4060",
            "fax_number": "770-270-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB INTERNAL MEDICINE ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-01",
        "last_updated": "2011-10-01",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-270-4060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "GA",
            "license": "046623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00815075B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Decatur Health and Wellness, LLC
• Dekalb Community Service Board
• Dekalb Community Service Board
• Dekalb Community Service Board
• Dekalb County Board of Commissioners (Dekalb County Fire Rescue)
• Dekalb Pediatric Associates PC (Health care)
• Dorothy Delisfort-Crisostomo, FNP-C
• Patricia L Delk Sr., DDS
• Patrick Dent, CPSAD,CPSMH
• Kacie Dentleegrand

• Primary Care Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2011; 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.