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Organization
MEDICAL DERMATOLOGY SPECIALISTS,PC
Active
Organization
MEDICAL DERMATOLOGY SPECIALISTS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE D WEISMAN M.D. (PHYSICIAN/OWNER)
(404) 939-9220
Entity
Organization
Contact information
Practice address
5730 GLENRIDGE DR, SUITE T-100, SANDY SPRINGS, GA 30328-6141
(404) 939-9220
(404) 939-9221
Mailing address
5730 GLENRIDGE DR, SUITE T-100, SANDY SPRINGS, GA 30328-6141
(404) 939-9220
(404) 939-9221
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
50088
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016848
MEDICARE RAILROAD
GA
01
—
07BBSST
MEDICARE ID
GA
01
—
202I075875
MEDICARE PTAN
GA
Enumeration date
02/20/2014
Last updated
08/31/2016
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