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General NPI Number Information
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NPI Number | 1942690094
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Entity Type | Organization
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Legal Business Name | MEDZED, LLC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/28/2015
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Provider Practice Location Address
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Address Line | 5555 PEACHTREE DUNWOODY RD SUITE 130
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City | ATLANTA
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State | GA
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Zip | 30342-1703
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Country | US
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Telephone | 404-382-8859
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Fax | 404-962-6803
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Provider Business Mailing Address
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Address Line | 5555 PEACHTREE DUNWOODY RD SUITE 130
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City | ATLANTA
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State | GA
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Zip | 30342-1703
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Country | US
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Telephone | 404-382-8859
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Fax | 404-962-6803
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. DAVID MATTHEW SHUSTER
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Credential |
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Telephone | 404-994-5866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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