Provider Demographics
NPI:1689392748
Name:ROYE, KAMESHA KALLIA
Entity Type:Individual
Prefix:
First Name:KAMESHA
Middle Name:KALLIA
Last Name:ROYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 CAMANO WAY
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8387
Mailing Address - Country:US
Mailing Address - Phone:404-304-3257
Mailing Address - Fax:
Practice Address - Street 1:626 CAMANO WAY
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-8387
Practice Address - Country:US
Practice Address - Phone:404-304-3257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver