Provider Demographics
NPI:1912286329
Name:ENCOUNTER MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:ENCOUNTER MEDICAL ASSOCIATES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS & INFO. SYSTEM
Authorized Official - Prefix:DR
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:IFARINDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-736-6000
Mailing Address - Street 1:PO BOX 4950
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30023-4950
Mailing Address - Country:US
Mailing Address - Phone:678-736-6000
Mailing Address - Fax:678-736-6004
Practice Address - Street 1:3075 RONALD REAGAN BLVD
Practice Address - Street 2:SUITE 501
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-6052
Practice Address - Country:US
Practice Address - Phone:678-736-6000
Practice Address - Fax:678-736-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Multi-Specialty
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003124192AMedicaid