Organization
PHOENIX MEDICAL GROUP OF GA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARRIE MADEJ D.O. (PRESIDENT)
(678) 814-4901
Entity
Organization
Contact information
Practice address
917 JONESBORO ROAD, MCDONOUGH, GA 30253-6031
(678) 814-4901
(678) 814-4908
Mailing address
P.O. BOX 740209, ATLANTA, GA 30370-4029
(678) 814-4901
(678) 814-4908
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
053123
GA
Other
Enumeration date
05/13/2011
Last updated
06/12/2014
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