MEDICARE: DR. KAMAU MOYENDA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	31391	GA

General Provider Information

NPI Number	:	1396893913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAMAU MOYENDA M.D.

Provider Business Mailing Address
First Line	:	925B PEACHTREE ST NE
Second Line	:	#323
City	:	ATLANTA
State	:	GA
Zip	:	30309-3918
Country	:	US
Telephone Number	:	404-630-3770
Fax Number	:

Provider Business Practice Location Address
First Line	:	925B PEACHTREE ST NE
Second Line	:	#323
City	:	ATLANTA
State	:	GA
Zip	:	30309-3918
Country	:	US
Telephone Number	:	404-630-3770
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	07/08/2007

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