Individual
SIMONNE DUPRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
240 CORPORATE CENTER DR, SUITE D, STOCKBRIDGE, GA 30281-7214
(770) 389-8855
(770) 506-7436
Mailing address
PO BOX 2666, STOCKBRIDGE, GA 30281-8928
(770) 389-8855
(770) 506-7436
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
040368
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00703205D
—
GA
Enumeration date
08/01/2006
Last updated
07/08/2007
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