Organization
CAEDEL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLAIRE K WILLIE MD (PHYSICIAN/OWNER)
(770) 907-4949
Entity
Organization
Contact information
Practice address
1324 HIGHWAY 138 SW, RIVERDALE, GA 30296-1404
(770) 907-4949
(770) 907-4022
Mailing address
PO BOX 9, FAYETTEVILLE, GA 30214-0009
(770) 907-4949
(770) 907-4022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
039177
GA
Other
Enumeration date
06/19/2006
Last updated
08/02/2011
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