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 provides Nephrology Physician services 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 Not confirmed with CMS for 15 years — call before visiting
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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