Provider Demographics
NPI:1043667934
Name:REALTIME CLINICS PC
Entity type:Organization
Organization Name:REALTIME CLINICS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:O
Authorized Official - Last Name:NWANERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:470-485-6342
Mailing Address - Street 1:1305 HEMBREE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3810
Mailing Address - Country:US
Mailing Address - Phone:470-485-6342
Mailing Address - Fax:678-878-4042
Practice Address - Street 1:1305 HEMBREE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3810
Practice Address - Country:US
Practice Address - Phone:470-485-6342
Practice Address - Fax:678-878-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA72609OtherMEDICAL LICENCE