# MEADOWS MED GROUP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003125881
- **Authorized official:** DAVID DERRER (CEO)
- **Authorized official phone:** (404) 667-9648

## Contact information

- **Practice address:** 4426 HUGH HOWELL RD, STE 429, TUCKER, GA 30084-4918
- **Practice address phone:** (404) 667-9648
- **Mailing address:** 4426 HUGH HOWELL RD, STE 429, TUCKER, GA 30084-4918
- **Mailing address phone:** (404) 667-9648

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 054181 | GA | Yes |

## Other

- **Enumeration date:** 09/28/2010
- **Last updated:** 10/27/2010