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Individual

KIMBERLEY N PRYOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
550 PEACHTREE ST NE RM 3356, ATLANTA, GA 30308-2247
(404) 686-6730
Mailing address
1080 PEACHTREE ST NE UNIT 1910, ATLANTA, GA 30309-6825

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101014424
MI
208M00000X
Hospitalist Physician
5101014424
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1578557559
NPI #
MI
05
4846727
MI
01
70-0-F32947-0
BCBS CPIN #
MI
01
KT014424
BCBSM
MI
Enumeration date
09/07/2005
Last updated
11/28/2018
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