Northern Professional Center Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

NORTHERN PROFESSIONAL CENTER INC

Practice address

2295 Towne Lake Pkwy
Suite 116-142
Woodstock, GA 30189-5520

Phone

(912) 322-3374

NPI assigned

Dec 6, 2007

Organization subpart

No

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

Authorized official

Name

Pablo M Sanu

Title

President

Phone

(912) 322-3374

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1619150232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 TOWNE LAKE PKWY",
            "address_2": "SUITE 116-142",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895520",
            "telephone_number": "912-322-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 TOWNE LAKE PKWY",
            "address_2": "SUITE 116-142",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895520",
            "telephone_number": "912-322-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN PROFESSIONAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "SANU",
        "authorized_official_first_name": "PABLO",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "912-322-3374"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Woodstock, GA
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• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.