Sommerville-Kelley, Moya Elizabeth

Sommerville-Kelley, Moya Elizabeth is an individual health care provider with primary practice located at 750 Town Park Lane Kaiser Permanente Town Park Medical Office, Kennesaw GA 30144. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Sommerville-Kelley, Moya Elizabeth can be contacted via phone (404) 365-0966.

Contact Information

Primary practice address
750 Town Park Lane Kaiser Permanente Town Park Medical Office Kennesaw GA 30144
Phone: (404) 365-0966
Fax: (770) 749-1119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 056924 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 56924 Georgia

Profile Details

NPI number 1699753921
LBN Legal business name Sommerville-Kelley, Moya Elizabeth
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated Apr 26th, 2012 - about 12 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 1699753921 NPPES
Georgia MEDICAID 197234226B
Georgia MEDICAID 197234226E
Georgia MEDICAID 197234226F
Georgia MEDICAID 197234226C
Georgia MEDICAID 197234226D

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