Organization
DUNWOODY PROFESSIONAL MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOINUDDIN KAZI MD (CEO)
(770) 455-8285
Entity
Organization
Contact information
Practice address
4480 N SHALLOWFORD RD, DUNWOODY, GA 30338-6410
(770) 455-8285
(770) 350-8973
Mailing address
2803 PRIESTCLIFF DR, SMYRNA, GA 30080-2195
(770) 455-8285
(770) 350-8973
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
042868
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000776432E
—
GA
Enumeration date
05/30/2008
Last updated
12/08/2009
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