DUNWOODY PROFESSIONAL MEDICAL INC NPI 1902064595

NPI Information

NPI: 1902064595
Provider Name: DUNWOODY PROFESSIONAL MEDICAL INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
4480 N SHALLOWFORD RD
DUNWOODY, GA
ZIP 30338
Phone: (770) 455-8285
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DUNWOODY PROFESSIONAL MEDICAL INC is a clinic center in Dunwoody, GA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). DUNWOODY PROFESSIONAL MEDICAL INC NPI is 1902064595. The provider is registered as an organization entity type.

The provider's business location address is:

4480 N SHALLOWFORD RD
DUNWOODY, GA
ZIP 30338-410
Phone: (770) 455-8285
Fax: (770) 350-8973

The provider's authorized official is Moinuddin Kazi .
The authorized official title is Ceo and has the following contact phone number (770) 455-8285.

The enumeration date for this NPI number is 5/30/2008 and was last updated on 12/8/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		042868	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000776432E	MEDICAID	GEORGIA
2	08BBVTG	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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