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Organization

GEORGIA KIDNEY ASSOCIATES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD DAVID HIMOT M..D. (PHYSICIAN)
(770) 427-7389
Entity
Organization

Contact information

Practice address
55 WHITCHER ST NE, SUITE 460, MARIETTA, GA 30060-1155
(770) 427-7389
(770) 427-2845
Mailing address
55 WHITCHER ST NE, SUITE 460, MARIETTA, GA 30060-1155
(770) 427-7389
(770) 427-2845

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300023127X
GA
Enumeration date
12/06/2005
Last updated
03/04/2013
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