Individual
MOYA ELIZABETH SOMMERVILLE-KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
750 TOWN PARK LANE, KAISER PERMANENTE TOWN PARK MEDICAL OFFICE, KENNESAW, GA 30144
(404) 365-0966
(770) 749-1119
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1736
(404) 364-7070
(770) 749-1119
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
056924
GA
207Q00000X
Family Medicine Physician
Primary
56924
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197234226B
—
GA
05
—
197234226C
—
GA
05
—
197234226D
—
GA
05
—
197234226E
—
GA
05
—
197234226F
—
GA
Enumeration date
01/06/2006
Last updated
04/26/2012
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