Individual
NASH DITMETAROJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2400 MOUNT ZION PKWY, KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER, JONESBORO, GA 30236-2500
(678) 906-3173
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 504-5678
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0002753
GA
152W00000X
Optometrist
Primary
OPT002753
GA
Other
Enumeration date
07/10/2013
Last updated
01/10/2022
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