Individual
HIRONOBU TAKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6043 PRESTLEY MILL RD STE B, DOUGLASVILLE, GA 30134-2280
(770) 941-8100
(678) 945-9331
Mailing address
6043 PRESTLEY MILL RD STE B, DOUGLASVILLE, GA 30134-2280
(770) 941-8100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
93245
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/11/2018
Last updated
04/19/2023
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