Organization
GAMD PCP MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KWASI BADU (MANAGER)
(480) 824-8446
Entity
Organization
Contact information
Practice address
5473 OLD FLOYD RD SW, MABLETON, GA 30126-2203
(480) 824-8446
Mailing address
5473 OLD FLOYD RD SW, MABLETON, GA 30126-2203
(480) 824-8446
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QP1100X
Podiatric Clinic/Center
—
—
305R00000X
Preferred Provider Organization
—
—
Other
Enumeration date
01/17/2025
Last updated
01/17/2025
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