American Brain, LLC
Organization Active NPI Preferred Provider Organization · Hinesville, GA
NPI 1689096828 · NPPES record last updated Jan 7, 2014
Key facts
- NPI
- 1689096828
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Preferred Provider Organization 305R00000X
- License
- 047893 (GA)
- Legal business name
- AMERICAN BRAIN, LLC
- Practice address
- 938 Elma G Miles Pkwy
Hinesville, GA 31313-4515 - Phone
- (912) 877-9111
- Fax
- (912) 877-5437
- NPI assigned
- Jan 7, 2014
- Organization subpart
- No
Authorized official
- Name
- Aderemi Dosunmu, M.D.
- Title
- Ceo
- Phone
- (912) 877-9111
National Provider Directory
Locations
938 Elma G Miles Pkwy
Hinesville, GA 31313
Phone (912) 294-4055
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Preferred Provider Organization | 305R00000X | 047893 | GA | Yes |
Addresses
Primary practice location
938 Elma G Miles Pkwy
Hinesville, GA 31313-4515
Mailing address
938 Elma G Miles Pkwy
Hinesville, GA 31313-4515
Phone (912) 877-9111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 802238916A | Medicaid | GA |
Other providers in Hinesville, GA
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- Amedisys Georgia, L.L.C
- Amedisys Georgia, LLC
- American Oncology Partners, P.a.
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- Amy Pearson, P.C.
- Braxton Ray Anderson
- Bre'on Monique Anderson
All providers in Hinesville, GA · Preferred Provider Organization in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.