Healthcare Provider Details

I. General information

NPI: 1386055499
Provider Name (Legal Business Name): RONALD NAKAI NETTEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2014
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1030 PITTS RD
SANDY SPRINGS GA
30350-4958
US

IV. Provider business mailing address

1030 PITTS RD
SANDY SPRINGS GA
30350-4958
US

V. Phone/Fax

Practice location:
  • Phone: 678-793-0094
  • Fax:
Mailing address:
  • Phone: 678-793-0094
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number78273
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberW3168
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35C.003212
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number349312
License Number StateLA
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberCDR.0006391
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: