Organization
MD WELLNESS CLINIC LLC
Active
Other names
MD weight loss and wellness Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
LAKSHMAN KUMAR DINAVAHI MD, MBA, FACP (OWNER)
(404) 217-9818
Entity
Organization
Contact information
Practice address
1124 N TENNESSEE ST STE 103, CARTERSVILLE, GA 30120-7938
(404) 217-9818
Mailing address
3505 LASSITER FALLS DR NE, MARIETTA, GA 30062-4199
(404) 217-9818
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/05/2024
Last updated
02/05/2024
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