Organization · Type 2 NPI
Ejese Healthcare, PC
Adult Medicine Physician · Villa Rica, GA
NPI number
1093800823
Active
Practice location
125 Commons Way Ste 203
Villa Rica, GA 30180-7041
Fax (770) 456-6227
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine Physician | 207Q00000X | 055684 (GA) |
| Adult Medicine Physician Primary | 207QA0505X | None listed |
Adult Medicine Physician: The NUCC recommends this code not be used. Choose a more appropriate code.
About NPI 1093800823
Ejese Healthcare, PC's National Provider Identifier is 1093800823, issued on Oct 4, 2006. The primary taxonomy on file is Adult Medicine Physician (207QA0505X), and the practice location is in Villa Rica, GA. The record was last updated on Sep 11, 2025.