Individual
AGNES NAMBIRO-KASOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 838-8824
(770) 838-8922
Mailing address
119 AMBULANCE DR, SUITE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
073901
GA
208M00000X
Hospitalist Physician
073901
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2012
Last updated
05/27/2015
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