Ewalola Ayo Ijaduola (NPI# 1306193016, PAC ID# 4789995929) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1306193016 |
| PAC ID by PECOS | 4789995929 |
| Professional Enrollment ID | I20190606000972 |
| Full Name | Ewalola Ayo Ijaduola |
| Organization Legal Name | SOUTHERN CRESCENT NEPHROLOGY PC |
| Address |
250 Village Ctr Pkwy Suite 100 Stockbridge GA 30281-9104 |
| Phone Number | 6782890508 |
| Gender | F |
| Graduation Year | 2007 |
| Primary Specialty | INTERNAL MEDICINE |
| Secondary Specialties | NEPHROLOGY |
| Group Practice PAC ID | 2466449269 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110165 | SOUTHERN REGIONAL MEDICAL CENTER |
| 110191 | PIEDMONT HENRY HOSPITAL |
| 110215 | PIEDMONT FAYETTE HOSPITAL |
| 110161 | NORTHSIDE HOSPITAL |
| 110031 | WELLSTAR SPALDING REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 | 6782890508 | SOUTHERN CRESCENT NEPHROLOGY PC |
| Organization Legal Name | SOUTHERN CRESCENT NEPHROLOGY PC |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Srikar Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Latoya R Williams | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Felice Rogers | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Muhammed Rahman | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Demetrious Blackmon | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Sanjay Sharma | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Janice Latrice Weatherspoon | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Uma Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Street Address |
250 VILLAGE CTR PKWY SUITE 100 |
| City | STOCKBRIDGE |
| State | GA |
| Zip | 30281-9104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Srikar Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Latoya R Williams | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Felice Rogers | Nurse Practitioner | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Muhammed Rahman | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Demetrious Blackmon | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Sanjay Sharma | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Janice Latrice Weatherspoon | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Uma Kumar | Nephrology | Southern Crescent Nephrology PC | 250 Village Ctr Pkwy, Suite 100, Stockbridge, GA 30281-9104 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Asad M Naqvi | Psychiatry | 135 Eagle Walk, Suite 150, Stockbridge, GA 30281 | |
| Earnest Darren Moore | Certified Registered Nurse Anesthetist (crna) | Anesthesia Solutions of Georgia LLC | 165 N Park Trail, Suite 100, Stockbridge, GA 30281 |
| Whatley B Fenlon | Psychologist, Clinical | 120 Martin Luther King Sr Heritage Trail, Suite 109, Stockbridge, GA 30281 | |
| German M Reyes | General Surgery | Gleneagles Surgery PC | 1215 Eagles Landing, Parkway Suite 105, Stockbridge, GA 30281 |
| Amanda L Hess | Chiropractic | 5430 N Henry Blvd, Suite 100, Stockbridge, GA 30281-3220 | |
| Richard D Buchanan | Chiropractic | 5124 N Henry Blvd, Stockbridge, GA 30281-3232 | |
| Porcia D Ewing | Chiropractic | 5459 N Henry Blvd, Suite C, Stockbridge, GA 30281-3265 | |
| Jeremy A Hess | Chiropractic | 5430 N Henry Blvd, Suite 100, Stockbridge, GA 30281-3270 | |
| Durie D Humber | Chiropractic | 165 Burke St, Suite 105, Stockbridge, GA 30281-3464 | |
| Carrie A Oberster | Chiropractic | 5008 N Henry Blvd, Stockbridge, GA 30281-3561 | |
| Find all physicians in zip 30281 | |||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | STOCKBRIDGE + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Ewalola Ayo Ijaduola.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.