Individual ProviderJiaqi MiInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806(770) 219-0023(770) 219-8420PECOS EnrollmentBased on the most recent information from CMS, provider Jiaqi Mi is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1215518774Provider TypeIndividualFull NameMi, JiaqiCredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/16/2021Last Updated8/7/2024Contact InformationPractice LocationPractice Address1439 Jesse Jewell Pkwy NE Ste 202, Gainesville, GA 30501-3806Phone(770) 219-0023FaxUnlisted FaxMailing LocationMailing AddressPO Box 742616, Atlanta, GA 30374-2616Phone(770) 219-8420FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense101328GeorgiaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer