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Individual

KENNETH MELBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2665 N DECATUR RD, SUITE 430, DECATUR, GA 30033-6149
(404) 294-4018
(404) 294-9161
Mailing address
2665 N DECATUR RD, SUITE 430, DECATUR, GA 30033-6149
(404) 294-4018
(404) 294-9161

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
26337
GA
207RP1001X
Pulmonary Disease Physician
Primary
26337
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000315169E
GA
05
000315169F
GA
05
000315169G
GA
Enumeration date
10/16/2006
Last updated
06/09/2014
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