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

Providence Medical Group, PC

Organization Internal Medicine Physician · NPI 1063570604

Providence Medical Group, PC is an Internal Medicine Physician in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

550 Peachtree St NE Ste 1285
Atlanta, GA 30308-2249
Phone: (404) 856-3213
Fax: (404) 856-3217
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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 · Licence 051703 (GA)

Record details

NPI number1063570604
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Oladayo Osinuga — President · (404) 684-7111
NPI enumeratedDecember 5, 2006
Last updated in NPPESJune 19, 2012
Mailing addressPo Box 4047, Macon, GA 31208-4047

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