Russell, Wendy Kiah

Russell, Wendy Kiah is an individual health care provider with primary practice located at 3999 Austell Rd Suite 901 Wellstreet Urgent Care, Austell GA 30106. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Russell, Wendy Kiah can be contacted via phone (770) 809-3032.

Contact Information

Primary practice address
3999 Austell Rd Suite 901 Wellstreet Urgent Care Austell GA 30106
Phone: (770) 809-3032
Fax: (678) 817-4058
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45442 Georgia
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 045442 Georgia

Profile Details

NPI number 1679575997
LBN Legal business name Russell, Wendy Kiah
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Nov 22nd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679575997 NPPES
Georgia MEDICAID 00836085H

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