Ijeoma Cecilia Anyanwu, MD | |
684 Sixes Rd Ste 275, Holly Springs, GA 30115-8723 | |
(770) 852-2440 | |
(770) 852-2446 |
Full Name | Ijeoma Cecilia Anyanwu |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 684 Sixes Rd Ste 275, Holly Springs, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1740418557 | NPI | - | NPPES |
003212061B | Medicaid | GA | |
003212061C | Medicaid | GA | |
04078011 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD446439 (Pennsylvania) | Secondary |
208000000X | Pediatrics | 274604 (New York) | Secondary |
208000000X | Pediatrics | 81221 (Georgia) | Primary |
Entity Name | The Southeast Permanente Medical Group |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
---|---|
Ijeoma Cecilia Anyanwu, MD 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8723 Ph: (770) 852-2440 | Ijeoma Cecilia Anyanwu, MD 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8723 Ph: (770) 852-2440 |
Nancy R Doelling, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 684 Sixes Rd, Ste 220, Holly Springs, GA 30115 Phone: 678-388-5485 Fax: 678-388-5489 | |
Dr. Samuel J Gold, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1120 Wellstar Way Ste 201, Holly Springs, GA 30114 Phone: 770-517-1900 Fax: 770-999-2506 | |
Dr. Jamie Hayes Rollins, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 684 Sixes Rd, Ste 220, Holly Springs, GA 30115 Phone: 678-388-5485 Fax: 678-388-5489 | |
Dr. Andrew Edward Doyle, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1120 Wellstar Way Ste 201, Holly Springs, GA 30114 Phone: 770-517-1900 |