Individual
MR. ALFRED FORNAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSCM
Contact information
Practice address
2727 PACES FERRY RD SE STE 750, ATLANTA, GA 30339-4053
(770) 694-1777
(678) 981-4601
Mailing address
2727 PACES FERRY RD SE STE 750, ATLANTA, GA 30339-4053
(770) 694-1777
(678) 981-4601
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
033-R-2053
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
82-4816080
—
GA
Enumeration date
11/08/2018
Last updated
11/08/2018
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