| Organization Name: | CENTER FOR GENERAL MEDICINE INC |
| NPI Number: | 1184876294 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BETH ROLLOLAZO (OFFICE MANAGER) |
| Mailing Address: | 809 W. Hwy 78 Suite D Villa Rica |
| State: | GA US |
| Postal Code: | 301801520 |
| Phone Number: | 7704569996 |
| Fax Number: | 7704569949 |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 07/13/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17551 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |