| Organization Name: | DUNWOODY MEDICAL GROUP |
| NPI Number: | 1114385820 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AVA BELL-TAYLOR (OWNER) |
| Mailing Address: | 5901 Peachtree Dunwoody Rd Suite C25 Atlanta |
| State: | GA US |
| Postal Code: | 303285382 |
| Phone Number: | 6784434000 |
| Fax Number: | |
| NPI Enumeration Date: | 02/09/2016 |
| NPI Last Update Date: | 02/09/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 031204 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |