Individual
AMANARH ALBERT KISSEIH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30045-7694
(678) 442-3317
(678) 442-4416
Mailing address
1960 SILVER HILL RD, STONE MOUNTAIN, GA 30087-1635
(770) 270-0505
(678) 442-4416
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
020880
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00342702A
—
GA
Enumeration date
04/03/2007
Last updated
07/08/2007
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