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NPI Code Detail

MEDICARE: KASHEW MEDICAL GROUP P.A.

MEDICARE: KASHEW MEDICAL GROUP P.A.
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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1619835352
Entity Type Code : Organization
Provider Name (Legal Business Name) : KASHEW MEDICAL GROUP P.A.
Provider Business Mailing Address
First Line : 976 BRADY AVE NW STE 100
Second Line :
City : ATLANTA
State : GA
Zip : 30318-5699
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 976 BRADY AVE NW STE 100
Second Line :
City : ATLANTA
State : GA
Zip : 30318-5699
Country : US
Telephone Number : 678-370-3967
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : CHIDINMA DAWN KABBA
Credential : MD
Telephone Number : 678-370-3967
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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