Organization
REPRODUCTIVE HEALTH MEDICINE & GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS KONGOASA (CMO)
(770) 450-8677
Entity
Organization
Contact information
Practice address
3965 HOLCOMB BRIDGE RD STE 100, NORCROSS, GA 30092-2203
(470) 535-9379
Mailing address
3965 HOLCOMB BRIDGE RD STE 100, NORCROSS, GA 30092-2203
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
Primary
—
—
Other
Enumeration date
07/18/2018
Last updated
09/06/2023
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