# MEDICAL WELLNESS GROUP

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

## Provider details

- **NPI number:** 1598000234
- **Authorized official:** BEVERLY IDRIS (OWNER/CEO)
- **Authorized official phone:** (770) 256-7033

## Contact information

- **Practice address:** 2015 MLK JR DRIVE, ATLANTA, GA 30310
- **Practice address phone:** (770) 256-7033
- **Practice address fax:** (678) 705-3717
- **Mailing address:** 1276 CEDAR KEYS CT, STONE MOUNTAIN, GA 30083-1811
- **Mailing address phone:** (770) 256-7033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 39485 | GA | Yes |

## Other

- **Enumeration date:** 12/06/2012
- **Last updated:** 12/06/2012