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Individual

DERRELL L NESMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSA

Contact information

Practice address
3091 COBB PKWY NW, KENNESAW, GA 30152-5891
(404) 932-0637
Mailing address
3091 COBB PKWY NW, KENNESAW, GA 30152-5891
(404) 932-0637

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
10/09/2009
Last updated
10/09/2009
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