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1114200029
BENAISSA KADDOUR DJEBBAR
AUGUSTA, GA
NPI
1114200029
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA APRN 204732)
Enumeration Date
2011-09-27
Last Update Date
2011-09-27
Business Address
-- BENAISSA KADDOUR DJEBBAR
3405 MIKE PADGETT HWY EAST CENTRAL REGIONAL HOSPITAL -FORENSIC UNIT
AUGUSTA, GA 30906-3815
Phone number: 706-792-7073
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Mailing Address
-- BENAISSA KADDOUR DJEBBAR
2060 DUNDEE WAY
GROVETOWN, GA 30813-8124
Phone number: 706-627-3762
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