| Mpm Group Llc | |
|
2430 Herodian Way Se Ste 210 Smyrna GA 30080-2980 | |
| (770) 933-9951 | |
| Not Available |
| Full Name | Mpm Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2430 Herodian Way Se Ste 210, Smyrna, Georgia |
| Authorized Official Name and Position | Godfrey O Ilonzo (PRESIDENT) |
| Authorized Official Contact | 7706928810 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mpm Group Llc 1135 Senoia Rd Tyrone GA 30290-1625 Ph: (770) 692-8810 | Mpm Group Llc 2430 Herodian Way Se Ste 210 Smyrna GA 30080-2980 Ph: (770) 933-9951 |
| NPI Number | 1013158302 |
|---|---|
| Provider Enumeration Date | 03/16/2009 |
| Last Update Date | 06/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013158302 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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