Covenant Family Medicine Gmg LLC

NPI #1346595204 in Dacula, Georgia

Provider Information

NPI Number: 1346595204
Entity Type: Organization
Organization Name: Covenant Family Medicine Gmg LLC
Subpart: Yes (part of a larger organization)
Parent Organization: GWINNETT MEDICAL GROUP
Primary Specialty: Family Medicine
Enumeration Date: Jul 17, 2012
Last Updated: Aug 23, 2013

Practice Location

Address: 2098 TERON TRCE
Address 2: SUITE 150
City: Dacula
State: Georgia
ZIP Code: 30019-1663
Phone: (678) 730-1620

Authorized Official

Name: MR. STEVEN A RUBIN
Title: EXECUTIVE DIRECTOR
Phone: (470) 325-0150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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