Provider Demographics
NPI:1144260043
Name:KENNAH, ADAM EDWIN (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:EDWIN
Last Name:KENNAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2365 HARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4901
Mailing Address - Country:US
Mailing Address - Phone:404-325-3024
Mailing Address - Fax:770-874-5469
Practice Address - Street 1:915 PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-5547
Practice Address - Country:US
Practice Address - Phone:740-891-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA056578207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine