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Individual

NICHOLAS KEMDI IHENACHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5329 MEMORIAL DR, SUITE A, STONE MOUNTAIN, GA 30083-3212
(404) 296-7695
(404) 296-7696
Mailing address
PO BOX 870828, STONE MOUNTAIN, GA 30087-0021
(404) 296-7695

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
038149
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000727108D
GA
Enumeration date
06/21/2006
Last updated
05/04/2015
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