Provider Demographics
NPI:1992009096
Name:MEDICUS HEALTH GROUP LLC
Entity type:Organization
Organization Name:MEDICUS HEALTH GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:YOLMAN
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-992-9130
Mailing Address - Street 1:3 RAVINIA DR
Mailing Address - Street 2:SUITE P 160
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2118
Mailing Address - Country:US
Mailing Address - Phone:770-643-2010
Mailing Address - Fax:770-643-2011
Practice Address - Street 1:3 RAVINIA DR
Practice Address - Street 2:SUITE P 160
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2118
Practice Address - Country:US
Practice Address - Phone:770-643-2010
Practice Address - Fax:770-643-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038600208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F83637Medicare UPIN