Individual
MAXWELL AGYEMANG PREMPEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 GENTILLY BLVD, CARTERSVILLE, GA 30120-8522
(770) 606-8359
(770) 382-5762
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
064054
GA
207RI0011X
Interventional Cardiology Physician
Primary
064054
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254330704A
—
GA
05
—
254330704B
—
GA
05
—
254330704C
—
GA
05
—
254330704D
—
GA
05
—
254330704E
—
GA
05
—
254330704F
—
GA
05
—
254330704G
—
GA
Enumeration date
12/14/2006
Last updated
09/21/2020
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