Search › Georgia › 163WC1500X
Remigius Idaewor
NPI 1801349204 · on the registry since 2016
Practice
- Address
- 110 Eagle Spring Dr
Suite C
Stockbridge, GA 30281 - Phone
- (678) 480-5315
- Organisation at this address
- Healthsource Agency Inc
House Of Preparation, Llc
Pacific Health Systems LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 163WC1500X
163WC1500X
- Also registered as
- 3747P1801X
374U00000X - Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-08-02
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