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

Hironobu Takeda, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1164929568

Hironobu Takeda, DO is an Internal Medicine in Douglasville, Georgia. Graduated from Philadelphia College of Osteopathic Medicine in 2018, 8 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
8
Trained at
Philadelphia College of Osteopathic Medicine
Licensed in
GA
In the registry since
2018
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

6043 Prestley Mill Rd Ste B
Douglasville, GA 30134-2280
Phone: (770) 941-8100
Fax: (678) 945-9331
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 665 Duluth Hwy Ste 401, Lawrenceville, GA 30046-4303 — (678) 312-4074
  • 300 W 27th St, Lumberton, NC 28358-3075 — (910) 671-5000

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 93245 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1164929568
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 11, 2018
Last updated in NPPESApril 19, 2023
Certification dateApril 19, 2023
Mailing address6043 Prestley Mill Rd Ste B, Douglasville, GA 30134-2280

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolPHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2018 (8 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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