Individual
JOSHUA FITZGERALD DETELICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
615 MICHAEL ST NE STE 205, ATLANTA, GA 30322-1047
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
85003
GA
207RP1001X
Pulmonary Disease Physician
Primary
85003
GA
Other
Enumeration date
04/27/2015
Last updated
07/24/2022
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