Individual
KYRIAKOS M. MICHAELIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1700 HOSPITAL SOUTH DR, SUITE 502, AUSTELL, GA 30106-6810
(770) 739-9555
(770) 732-8110
Mailing address
1700 HOSPITAL SOUTH DR, SUITE 502, AUSTELL, GA 30106
(678) 741-2317
(678) 741-2301
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
016644
GA
207RG0100X
Gastroenterology Physician
Primary
016644
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000012801E
—
GA
Enumeration date
02/08/2006
Last updated
07/23/2009
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