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General NPI Number Information
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NPI Number | 1588506174
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Entity Type | Individual
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Provider Name | KENNETH HERBERT DREWERY III EP-C, CET
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Gender | Male
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 125 DECATUR ST SE
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City | ATLANTA
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State | GA
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Zip | 30303-3201
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Country | US
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Telephone | 404-413-8050
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Fax |
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Provider Business Mailing Address
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Address Line | 1880 E HARRISON ST
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City | CHANDLER
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State | AZ
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Zip | 85225-9075
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Country | US
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Telephone |
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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 | 246W00000X
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Taxonomy Name | Cardiology Technician
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License Number | Z5Q5N4X3
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 224Y00000X
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Taxonomy Name | Clinical Exercise Physiologist
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License Number | 2001337
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License Number State | GA
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