Individual
DOMINIK KISSING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
Mailing address
5780 PEACHTREE DUNWOODY ROAD, SUITE 300, ATLANTA, GA 30342-7927
(678) 891-6541
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
64125
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003112332D
—
GA
Enumeration date
04/20/2006
Last updated
08/16/2017
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