Organization
EASTSIDE PREMIER NEPHROLOGY & HYPERTENSION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLADAPO FALASE (OFFICE MANAGER)
(678) 413-3261
Entity
Organization
Contact information
Practice address
1612 MILSTEAD RD NE, SUITE A, CONYERS, GA 30012-3738
(678) 413-3261
(678) 413-3580
Mailing address
PO BOX 1157, COVINGTON, GA 30015-1157
(678) 413-3261
(678) 413-3580
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
044714
GA
Other
Enumeration date
05/03/2007
Last updated
03/22/2011
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