Individual
MICHAEL DAREN MUDREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3540 COBB PKWY, STE 100, ACWORTH, GA 30101
(706) 632-3711
Mailing address
PO BOX 1332, MC CAYSVILLE, GA 30555-1332
(706) 632-3711
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
038564
GA
208600000X
Surgery Physician
Primary
38564
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000621398J
—
GA
Enumeration date
07/05/2006
Last updated
02/11/2020
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