Madu Medical Group, P.c. | |
1815 Highway 138 Se Ste 800 Conyers GA 30013-2098 | |
(770) 929-0404 | |
(770) 929-0540 |
Full Name | Madu Medical Group, P.c. |
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Speciality | Clinic/Center |
Location | 1815 Highway 138 Se Ste 800, Conyers, Georgia |
Authorized Official Name and Position | Ndidi Eugene Madu (PRESIDENT) |
Authorized Official Contact | 3179460591 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Madu Medical Group, P.c. Po Box 83042 Conyers GA 30013-8014 Ph: () - | Madu Medical Group, P.c. 1815 Highway 138 Se Ste 800 Conyers GA 30013-2098 Ph: (770) 929-0404 |
NPI Number | 1457753972 |
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Provider Enumeration Date | 09/16/2014 |
Last Update Date | 09/16/2014 |
Medicare PECOS PAC ID | 7618292590 |
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Medicare Enrollment ID | O20150218000144 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457753972 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | 65703 (Georgia) | Primary |
Provider Name | Ndidi E Madu |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457587842 PECOS PAC ID: 8527238930 Enrollment ID: I20110823000089 |
Provider Name | April Madu |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629206529 PECOS PAC ID: 4587810460 Enrollment ID: I20120808000676 |
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