Brody, Evan M
Brody, Evan M is an individual health care provider with primary practice located at 5205 Stilesboro Rd Nw Ste 205 , Kennesaw GA 30152-7765. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Brody, Evan M can be contacted via phone (678) 310-0540.Contact Information
Primary practice address
5205 Stilesboro Rd Nw Ste 205
Kennesaw GA 30152-7765
Phone: (678) 310-0540
Fax: (678) 310-0538
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | POD000937 | Georgia |
Profile Details
| NPI number | 1679548168 |
|---|---|
| LBN Legal business name | Brody, Evan M |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 20th, 2006 |
| Last updated | Jul 21st, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679548168 | NPPES |
| Georgia | Other | 581994261 | FIRST HEALTH |
| Georgia | Other | 2700264 | FIRST HEALTH |
| Georgia | Other | 581994261 | FIRST HEALTH |
| Georgia | Other | 1400101 | FIRST HEALTH |
| Georgia | MEDICAID | 457858901A | FIRST HEALTH |
| Georgia | Other | 10055122 | FIRST HEALTH |
| Georgia | Other | 581994261 | FIRST HEALTH |
| Georgia | Other | 3262431 | FIRST HEALTH |
| Georgia | Other | 6241458 | FIRST HEALTH |
| Georgia | Other | 2701694 | FIRST HEALTH |
| Georgia | MEDICAID | 332208 | FIRST HEALTH |
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