Dunwoody Professional Medical Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

042868 Issued in GA

Legal business name

DUNWOODY PROFESSIONAL MEDICAL INC

Practice address

4480 N Shallowford Rd
Dunwoody, GA 30338-6410

Phone

(770) 455-8285

Fax

(770) 350-8973

NPI assigned

May 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Moinuddin Kazi, MD

Title

Ceo

Phone

(770) 455-8285

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260230400000",
    "number": "1902064595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 PRIESTCLIFF DR",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802195",
            "telephone_number": "770-455-8285",
            "fax_number": "770-350-8973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 N SHALLOWFORD RD",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386410",
            "telephone_number": "770-455-8285",
            "fax_number": "770-350-8973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNWOODY PROFESSIONAL MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2009-12-08",
        "status": "A",
        "authorized_official_last_name": "KAZI",
        "authorized_official_first_name": "MOINUDDIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-455-8285",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "042868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000776432E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dunwoody Health and Wellness Center
• Dunwoody Labs Inc
• Dunwoody Obstetrics & Gynecology, PC
• Dunwoody Pediatrics
• Dunwoody Personal Health Care PC
• Dunwoody Village Clinic, PC
• Dunwoody Wellness
• Anthony Michael Dupree Jr.
• John H Eaton
• Nneanata Ijele Echetebu

• Clinic/Center in Dunwoody, GA
• Providers in Dunwoody, GA by specialty
• Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.