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Contact Information

MICHAEL D MUDREY, DO
3540 COBB PKWY
STE 100
ACWORTH, GA30101
 Phone: 706-632-3711
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for MICHAEL D MUDREY · (Male)

NPI # 1376574863
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/05/2006
Last updated 02/11/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 038564
  • GA License # 38564
  • GA Medicaid 000621398J
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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