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:
Health care specialties
Specialty | Code | License # | 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 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1679575997 | NPPES |
Georgia | MEDICAID | 00836085H |
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