Provider Demographics
NPI:1053318808
Name:REZK, MAGDY W (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:W
Last Name:REZK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3203 S CHEROKEE LN. STE 220
Mailing Address - Street 2:WEATHERSTONE MEDICAL CARE LLC.
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188
Mailing Address - Country:US
Mailing Address - Phone:770-675-6025
Mailing Address - Fax:770-675-7814
Practice Address - Street 1:3203 S CHEROKEE LN.
Practice Address - Street 2:STE 220 WEATHERSTONE MEDICAL CARE LLC.
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4461
Practice Address - Country:US
Practice Address - Phone:770-675-6025
Practice Address - Fax:770-675-7814
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2023-03-07
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Provider Licenses
StateLicense IDTaxonomies
GA053936207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA249270OtherBLUE CROSS/BLUE SHIELD #
GA053936OtherGEORGIA MEDICAL LICENSE #
BR8625571OtherDEA REGISTRATION NUMBER
GA053936OtherGEORGIA MEDICAL LICENSE #
GA111883Medicare Oscar/Certification
BR8625571OtherDEA REGISTRATION NUMBER