Organization
MEDICAL WELLNESS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEVERLY IDRIS (OWNER/CEO)
(770) 256-7033
Entity
Organization
Contact information
Practice address
2015 MLK JR DRIVE, ATLANTA, GA 30310
(770) 256-7033
(678) 705-3717
Mailing address
1276 CEDAR KEYS CT, STONE MOUNTAIN, GA 30083-1811
(770) 256-7033
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
39485
GA
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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