KENNESAW MOUNTAIN MEDICAL GROUP is a primary care clinic center in Kennesaw, GA. KENNESAW MOUNTAIN MEDICAL GROUP NPI is 1235378324. The provider is registered as an organization entity type.
The provider's business location address is:
1600 KENNESAW DUE WEST RD NW
BUILDING 600 SUITE 625
KENNESAW, GA
ZIP 30152-301
Phone: (770) 422-5880
The provider's authorized official is Gregory J Matechak .
The authorized official title is Physician and has the following contact phone number (770) 422-5880.
The CLIA number assigned to this NPI record is 11D1099359 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 2/12/2009 and was last updated on 2/12/2009.