Individual
DR. MICHAEL DATTILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1365B CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5360
(404) 778-4849
Mailing address
1365B CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5360
(404) 778-4849
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
073433
GA
207WX0109X
Neuro-ophthalmology Physician
Primary
073433
GA
Other
Enumeration date
05/25/2011
Last updated
01/08/2021
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