| Dunwoody Professional Medical Inc | |
|
4480 N Shallowford Rd Dunwoody GA 30338-6410 | |
| (770) 455-8285 | |
| (770) 350-8973 |
| Full Name | Dunwoody Professional Medical Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 4480 N Shallowford Rd, Dunwoody, Georgia |
| Authorized Official Name and Position | Moinuddin Kazi (CEO) |
| Authorized Official Contact | 7704558285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dunwoody Professional Medical Inc 2803 Priestcliff Dr Smyrna GA 30080-2195 Ph: (770) 455-8285 | Dunwoody Professional Medical Inc 4480 N Shallowford Rd Dunwoody GA 30338-6410 Ph: (770) 455-8285 |
| NPI Number | 1902064595 |
|---|---|
| Provider Enumeration Date | 05/30/2008 |
| Last Update Date | 12/08/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902064595 | NPI | - | NPPES |
| 000776432E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 042868 (Georgia) | Primary |
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