Individual
KOJI NISHIMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
COMMANDER, USAMEDDAC AND MARTIN ARMY COMMUNITY HOSPITAL, 7950 MARTIN LOOP, FORT BENNING, GA 31905
(706) 544-4618
(706) 544-3163
Mailing address
COMMANDER, USAMEDDAC AND MARTIN ARMY COMMUNITY HOSPITAL, 7950 MARTIN LOOP, FORT BENNING, GA 31905
(706) 544-4618
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0101054889
VA
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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