Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blueglove Primary Care LLC

Organization Internal Medicine Physician · NPI 1891616876

Blueglove Primary Care LLC is an Internal Medicine Physician in Marietta, Georgia. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

815 Pine Mnr
Marietta, GA 30066-3837
Phone: (770) 405-9320
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1891616876
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jiexi Liao — Managing Member · (770) 405-9320
NPI enumeratedJuly 23, 2026
Last updated in NPPESJuly 23, 2026
Certification dateJuly 23, 2026
Mailing address815 Pine Mnr, Marietta, GA 30066-3837

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