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Search › Georgia › 246RP1900X

Idesta Ralph

NPI 1205235371 · on the registry since 2014 · sole proprietor

Practice

Address
1015 Tyrone Rd # 410-C
Tyrone, GA 30290
Phone
(470) 818-2264
Fax
(866) 984-3729
Organisation at this address
Idesta Medical Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
246RP1900X
246RP1900X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-06-10

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia