Healthcare Provider Details

I. General information

NPI: 1841604980
Provider Name (Legal Business Name): NIKHAR KINGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

1984 PEACHTREE RD NW STE 505
ATLANTA GA
30309-5219
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5000
  • Fax:
Mailing address:
  • Phone: 404-352-1409
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number84885
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: