NPIMap

Organization Active NPI

Vitale Medical Inc

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1609259969
Registry record updated Jul 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
067173 Issued in GA
Legal business name
VITALE MEDICAL INC
Practice address
3290 Memorial Dr Ste B1
Decatur, GA 30032-3400
Phone
(404) 534-9692
NPI assigned
Jul 6, 2015
Last updated
Jul 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2015

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

Authorized official

Name
Miguelita Bhuiyan
Title
Administrator
Phone
(770) 990-6811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 067173 GA Primary

Addresses

Primary practice location

3290 Memorial Dr Ste B1
Decatur, GA 30032-3400

Mailing address

PO Box 350
Duluth, GA 30096-0006

National Provider Directory

National Provider Directory

Locations

3290 Memorial Dr
Ste B1
Decatur, GA 30032
Phone (404) 289-2931

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1436140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436140800000",
    "number": "1609259969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 350",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300960006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 MEMORIAL DR STE B1",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300323400",
            "telephone_number": "404-534-9692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALE MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-06",
        "last_updated": "2015-07-06",
        "status": "A",
        "authorized_official_last_name": "BHUIYAN",
        "authorized_official_first_name": "MIGUELITA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-990-6811"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "067173",
            "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 Jul 6, 2015; 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.