Individual
KINZI V SHEWMAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 SIGMAN RD NE STE 230, CONYERS, GA 30012
(678) 609-4912
Mailing address
2727 PACES FERRY RD SE STE 1-1100, ATLANTA, GA 30339-6151
(470) 271-3418
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
072928
GA
207Q00000X
Family Medicine Physician
11012924
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003160187A
—
GA
05
—
200924280
—
IN
Enumeration date
08/11/2006
Last updated
08/07/2018
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