Provider Demographics
NPI:1366159873
Name:MIM URGENT CARE & FAMILY PRACTICE INC
Entity type:Organization
Organization Name:MIM URGENT CARE & FAMILY PRACTICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:AKOSUAH
Authorized Official - Last Name:QUARSHIE
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:678-515-8154
Mailing Address - Street 1:5380 PEACHTREE INDUSTRIAL BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30071-1565
Mailing Address - Country:US
Mailing Address - Phone:678-515-8154
Mailing Address - Fax:
Practice Address - Street 1:5380 PEACHTREE INDUSTRIAL BLVD STE 150
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1565
Practice Address - Country:US
Practice Address - Phone:678-515-8154
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty