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NPI Code Detail

MEDICARE: CLEAVER MEDICAL GROUP PC

MEDICARE: CLEAVER MEDICAL GROUP PC
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
1208VP0014XInterventional Pain Medicine Physician

General Provider Information

NPI Number : 1679018485
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLEAVER MEDICAL GROUP PC
Provider Business Mailing Address
First Line : 59 TIPTON DR
Second Line :
City : DAHLONEGA
State : GA
Zip : 30533-1603
Country : US
Telephone Number : 770-872-6179
Fax Number : 678-302-6127
Provider Business Practice Location Address
First Line : 105 PROFESSIONAL PARK DR
Second Line :
City : CUMMING
State : GA
Zip : 30040-2381
Country : US
Telephone Number : 770-872-6179
Fax Number : 678-302-6127
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : ASHLEY N DORSEY
Credential :
Telephone Number : 770-746-6380
Provider Enumeration Date : 01/03/2017
Last Update Date : 12/02/2025

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Directions to “CLEAVER MEDICAL GROUP PC ” Practice Location

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