Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eastside Premier Nephrology & Hypertension PC

Organization Nephrology Physician · NPI 1104048651

Eastside Premier Nephrology & Hypertension PC is a Nephrology Physician in Conyers, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1612 Milstead Rd NE Ste A
Conyers, GA 30012-3738
Phone: (678) 413-3261
Fax: (678) 413-3580
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nephrology Physician (primary) Taxonomy 207RN0300X · Licence 044714 (GA)

Record details

NPI number1104048651
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Oladapo Falase — Office Manager · (678) 413-3261
NPI enumeratedMay 3, 2007
Last updated in NPPESMarch 22, 2011
Mailing addressPo Box 1157, Covington, GA 30015-1157

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