Provider Type Icon

KENNESAW HEALTH AND WELLNESS CENTER LLC NPI 1225505217


NPI Information

NPI: 1225505217
Provider Name: KENNESAW HEALTH AND WELLNESS CENTER LLC
Classification: Obstetrics & Gynecology - 207VG0400X
Entity Type: Organization

Specialization: Gynecology

CLIA Number: 11D2060232

Address:
1595 KENNESAW DUE WEST RD NW STE 100
KENNESAW, GA
ZIP 30152
Phone: (470) 308-3365
Get Directions

KENNESAW HEALTH AND WELLNESS CENTER LLC is a gynecology obstetrics gynecology in Kennesaw, GA. The provider is a physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee KENNESAW HEALTH AND WELLNESS CENTER LLC NPI is 1225505217. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1595 KENNESAW DUE WEST RD NW STE 100
KENNESAW, GA
ZIP 30152-640
Phone: (470) 308-3365
Fax: (770) 627-5228

The provider's authorized official is Angel S Paas .
The authorized official title is Physician Owner and has the following contact phone number (678) 773-1130.

The CLIA number assigned to this NPI record is 11D2060232 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/28/2018 and was last updated on 12/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207VG0400XObstetrics & GynecologyGynecologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.