Individual
DAMIEN ANTOINE DOUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1462 MONTREAL RD, STE 218, TUCKER, GA 30084-6929
(470) 294-0863
(470) 294-0889
Mailing address
1462 MONTREAL ROAD, STE 218, TUCKER, GA 30084-6929
(470) 294-0863
(404) 294-0889
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
053852
GA
174400000X
Specialist
53852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
728513163A
—
GA
Enumeration date
10/04/2005
Last updated
09/02/2016
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