Provider Demographics
NPI:1558184002
Name:AMERICAN INTEGRATIVE MEDICINE LLC
Entity type:Organization
Organization Name:AMERICAN INTEGRATIVE MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAYKRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DARJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-208-3460
Mailing Address - Street 1:767 PEACHTREE PKWY STE 4
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9348
Mailing Address - Country:US
Mailing Address - Phone:678-208-3460
Mailing Address - Fax:678-374-4902
Practice Address - Street 1:767 PEACHTREE PKWY STE 4
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-9348
Practice Address - Country:US
Practice Address - Phone:678-208-3460
Practice Address - Fax:678-374-4902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty