Main Street Internal Medicine & Pediatrics PC
NPI 1619155306ActiveOrganization· Pediatrics· Alpharetta, GA
Pediatrics in Alpharetta, Georgia, registered in NPPES in February 2008. The authorized official on file is Maribel Labindalawa Angka Servera, MD, Physician. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1619155306 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 5, 2008 |
| Last updated in NPPES | Jan 22, 2009 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pediatrics Primary | 208000000X | 047388 | GA |
| Internal Medicine | 207R00000X | 047657 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (GA) |
|---|
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