Individual
REMIGIUS IDAEWOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 EAGLE SPRING DR, SUITE C, STOCKBRIDGE, GA 30281-6488
(678) 480-5315
Mailing address
110 EAGLE SPRING DR, SUITE C, STOCKBRIDGE, GA 30281-6488
(678) 480-5315
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
PHCP009529
GA
3747P1801X
Personal Care Attendant
PHCP009529
GA
374U00000X
Home Health Aide
PHCP009529
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHCP009529
GEORGIA DEPARTMENT OF COMMUNITY HEALTH
GA
Enumeration date
08/02/2016
Last updated
08/02/2016
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