Individual
DR. MARK WILLIAM EL-DEIRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
775 POPLAR RD STE 240, NEWNAN, GA 30265-8300
(770) 400-7830
Mailing address
775 POPLAR RD STE 240, NEWNAN, GA 30265-8300
(770) 400-7830
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
66483
GA
207Y00000X
Otolaryngology Physician
ME 98348
FL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
66483
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278414900
—
FL
01
—
96608
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/01/2006
Last updated
07/30/2025
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