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

Kenyatta Mireku, MD

Individual provider Dermatology Physician · NPI 1740600048

Kenyatta Mireku, MD is a Dermatology in Lawrenceville, Georgia. Graduated from Medical College of Georgia School of Medicine in 2014, 12 years ago. Practices with Advanced Dermatology of Georgia, LLC, a 15-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
12
Trained at
Medical College of Georgia School of Medicine
Licensed in
GA
In the registry since
2014
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

771 Old Norcross Rd Ste 260
Lawrenceville, GA 30046-4981
Phone: (770) 962-5040
Fax: (770) 962-5056
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 080834 (GA)

Record details

NPI number1740600048
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 24, 2014
Last updated in NPPESOctober 2, 2018

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Advanced Dermatology Of Georgia, Llc — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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