Organization
MPM GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GODFREY O ILONZO (PRESIDENT)
(770) 692-8810
Entity
Organization
Contact information
Practice address
2430 HERODIAN WAY SE STE 210, SMYRNA, GA 30080-2980
(770) 933-9951
Mailing address
1135 SENOIA RD, TYRONE, GA 30290-1625
(770) 692-8810
(770) 692-8815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/16/2009
Last updated
06/28/2011
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