Gwinnett Family Medicine

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

52073 Issued in GA

Legal business name

GWINNETT FAMILY MEDICINE

Practice address

510 Grayson Hwy
Lawrenceville, GA 30045-6332

Phone

(770) 995-9565

NPI assigned

Oct 15, 2007

Organization subpart

No

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

Authorized official

Name

Syed A Ali

Title

Practice Manager

Phone

(770) 910-2377

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330300800000",
    "number": "1619166717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 GRAYSON HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456332",
            "telephone_number": "770-995-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 GRAYSON HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300456332",
            "telephone_number": "770-995-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2012-02-27",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-910-2377"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "52073",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189134074A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gwinnett Endoscopy Center, PC
• Gwinnett Family Dental Care
• Gwinnett Family Medicine and Geriatrics
• Gwinnett General Medicine
• Gwinnett Gynecology and Obstetrics
• Gwinnett Heart Specialists LLC
• Gwinnett Hospital System Gme, LLC

• Internal Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; 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.