Ange Tetsadjio, PHARM.D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

033137 Issued in GA

Practice address

3200 Holcomb Bridge Rd
Peachtree Corners, GA 30092-3361

Phone

(404) 671-5297

NPI assigned

Feb 1, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1982357778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4895 POST OAK TRITT RD NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754058",
            "telephone_number": "404-375-1526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 HOLCOMB BRIDGE RD",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923361",
            "telephone_number": "404-671-5297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4895 Post Oak Tritt Rd NE",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300754058",
            "country_code": "US",
            "telephone_number": "404-375-1526",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TETSADJIO",
        "first_name": "ANGE",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "033137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacist in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.