Idc Medical LLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

IDC MEDICAL LLC

Practice address

5400 Laurel Springs Pkwy Ste 1404
Suwanee, GA 30024-6098

Phone

(678) 347-2153

NPI assigned

Mar 26, 2019

Organization subpart

No

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

Authorized official

Name

Mr. John Kyle Stellbauer

Title

Ceo

Phone

(678) 347-2153

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Christopher Ketterer, M.D.

  • Infectious Disease Physician
  • Lawrenceville, GA
  • NPI 1134393796
  NPD (past)
• Karuna Kusan, M.D.

  • Infectious Disease Physician
  • Lawrenceville, GA
  • NPI 1013921329
  NPD (past)
• Zola Nlandu, MD

  • Internal Medicine Physician
  • Athens, GA
  • NPI 1821451873
  NPD (past)
• Tzvetan Vassilev, MD

  • Infectious Disease Physician
  • Lawrenceville, GA
  • NPI 1619980893
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662681600000",
    "number": "1912468620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 LAUREL SPRINGS PKWY STE 1404",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246098",
            "telephone_number": "678-347-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 LAUREL SPRINGS PKWY STE 1404",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246098",
            "telephone_number": "678-347-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDC MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A",
        "authorized_official_last_name": "STELLBAUER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "KYLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-347-2153",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Maria Hyland, LPC
• Hypertension & Kidney Consultants of Georgia PC
• Andrew Eunsuk Hyun, D.C.
• Byeong Su Hyun, D.C, L AC.
• Icare Specialists of Warrior, Inc.
• Kaitlyn Ide, LPC
• Ideal Minds Behavioral Services
• Chidi Ogochukwu Ifedi, RPH
• Adaora Ijeoma Ikeokwu
• Amber J Illum, LPC

• Infectious Disease Physician in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Infectious Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.