Gwinnett Infectious Diseases PC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

GWINNETT INFECTIOUS DISEASES PC

Practice address

1960 Riverside Pkwy
Suite 101
Lawrenceville, GA 30043-5945

Phone

(770) 995-0466

Fax

(770) 995-0472

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Elliot G Raizes, MD

Title

President

Phone

(770) 995-0466

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343001600000",
    "number": "1679658702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 RIVERSIDE PKWY",
            "address_2": "SUITE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435945",
            "telephone_number": "770-995-0466",
            "fax_number": "770-995-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1960 RIVERSIDE PKWY",
            "address_2": "SUITE 101",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435945",
            "telephone_number": "770-995-0466",
            "fax_number": "770-995-0472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GWINNETT INFECTIOUS DISEASES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-07-23",
        "status": "A",
        "authorized_official_last_name": "RAIZES",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-995-0466",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Lawrenceville, GA
• Infectious Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.