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Individual

MS. NAKATO B. KIBUYAGA-TRAVIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
6043 PRESTLEY MILL RD STE B, DOUGLASVILLE, GA 30134-2280
(770) 947-3000
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1736
(404) 364-7070
(678) 336-7099

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
003467
GA
207Q00000X
Family Medicine Physician
Primary
066960
GA

Other

Enumeration date
07/18/2008
Last updated
10/10/2019
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