Healthcare Provider Details

I. General information

NPI: 1669113718
Provider Name (Legal Business Name): BRITTANY RASHANNE GUY BUNDY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 NORTHSIDE FORSYTH DR
CUMMING GA
30041-7659
US

IV. Provider business mailing address

PO BOX 568
MARIETTA GA
30061-0568
US

V. Phone/Fax

Practice location:
  • Phone: 770-844-3200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number104403
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: