Doctor Name: | MS. MARY JOY AC IHEANACHO |
NPI Number: | 1629054010 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 056574 |
Business Practice Address: | 3650 Steve Reynolds Blvd. Kaiser Permanente Gwinnett Medical Office Duluth, GA - 30096 |
Business Phone Number: | 7709316110 |
Business Fax Number: | |
Mailing Address: | 3495 Piedmont Road, Ne, ATLANTA |
State: | GA |
Postal Code: | 30305 |
Phone Number: | 4043647070 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2005 |
NPI Last Update Date: | 02/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 056574 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |