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Individual

MICHAEL T KISSEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
151 LEE BYRD RD, LOGANVILLE, GA 30052-2310
(678) 587-5993
(678) 587-5997
Mailing address
151 LEE BYRD RD, LOGANVILLE, GA 30052-2310
(770) 633-5513

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
060394
GA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
060394
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
519873093A
GA
Enumeration date
05/31/2007
Last updated
04/05/2022
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