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General NPI Number Information
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NPI Number | 1558824011
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Entity Type | Individual
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Provider Name | YORDANOS MESFIN AGAJYELLEH MD
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Gender | Female
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Dates
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Enumeration Date | 04/11/2019
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 2985 MACK DOBBS RD NW
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City | KENNESAW
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State | GA
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Zip | 30152-2641
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Country | US
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Telephone | 770-268-4011
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Fax | 770-955-4278
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Provider Business Mailing Address
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Address Line | 3333 RIVERWOOD PKWY SE STE 250
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City | ATLANTA
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State | GA
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Zip | 30339-3304
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Country | US
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Telephone | 770-914-0016
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | U2762
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 99224
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License Number State | GA
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