Meadows Med Group INC
Family Medicine in Tucker, GA. Organization (NPI-2).
NPI number1003125881
StatusActive
Last updated in NPPESOct 27, 2010
Details
- NPI
- 1003125881
- Entity type
- Organization (NPI-2)
- Legal business name
- Meadows Med Group INC
- Organization subpart
- No
- Enumeration date
- Sep 28, 2010
- Last updated
- Oct 27, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 054181 | GA | Yes |
Practice location
4426 Hugh Howell RdSte 429
Tucker, GA 30084-4918
Phone 404-667-9648
Mailing address
4426 Hugh Howell RdSte 429
Tucker, GA 30084-4918
Phone 404-667-9648
Authorized official
David Derrer
Ceo
4046679648
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