Individual
KANEY JERVELLE FEDOVSKIY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
80 JESSE HILL JR DR SE, #26024, ATLANTA, GA 30303-3031
(404) 616-6689
(404) 616-0207
Mailing address
170 BOULEVARD SE, APT #E122, ATLANTA, GA 30312-2325
(404) 441-0477
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
054710
GA
2084P0800X
Psychiatry Physician
A97005
CA
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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