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NPI Code Detail

MEDICARE: M MEDICAL GROUP, INC.

MEDICARE: M MEDICAL GROUP, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1548025018
Entity Type Code : Organization
Provider Name (Legal Business Name) : M MEDICAL GROUP, INC.
Provider Business Mailing Address
First Line : PO BOX 931343
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1343
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 520 GLENBURN AVE
Second Line :
City : CAMBRIDGE
State : MD
Zip : 21613-1415
Country : US
Telephone Number : 410-228-9191
Fax Number :
Authorized Official
Title or Position : BILLING MANAGER
Name : KRYSTLE D BROWN
Credential :
Telephone Number : 410-870-9380
Provider Enumeration Date : 02/14/2024
Last Update Date : 02/14/2024

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