Individual provider Active NPI

Maxwell Armand Eidex, MD

  • Internal Medicine Physician
  • Decatur, GA
National Provider Identifier
1326154790
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
9808 Issued in GA
Practice address
487 Winn Way
Decatur, GA 30030
Phone
(404) 294-0702
Fax
(404) 299-7499
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 9808 GA Primary

Addresses

Primary practice location

487 Winn Way
Decatur, GA 30030

Mailing address

2911 Greenbush Place
Atlanta, GA 30345
Phone (770) 938-4171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1326154790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 GREENBUSH PLACE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30345",
            "telephone_number": "770-938-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "30030",
            "telephone_number": "404-294-0702",
            "fax_number": "404-299-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDEX",
        "first_name": "MAXWELL",
        "middle_name": "ARMAND",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "9808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.