Provider Demographics
NPI:1174355663
Name:AGAPE FAMILY MEDICINE, P.C.
Entity type:Organization
Organization Name:AGAPE FAMILY MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BEDE SOON
Authorized Official - Middle Name:TAE
Authorized Official - Last Name:CHA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:770-876-5096
Mailing Address - Street 1:3265 PEACHTREE PKWY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1036
Mailing Address - Country:US
Mailing Address - Phone:770-876-5096
Mailing Address - Fax:
Practice Address - Street 1:3265 PEACHTREE PKWY
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1036
Practice Address - Country:US
Practice Address - Phone:770-876-5096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty