Individual
MARK KISHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 LARNE CT, ROSWELL, GA 30076-4446
(678) 592-9005
Mailing address
100 LARNE CT, ROSWELL, GA 30076-4446
(678) 592-9005
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35657
MA
Other
Enumeration date
09/18/2007
Last updated
09/18/2007
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