Organization
NORTH GEORGIA DERMATOPATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDSAY CATHERINE JERDAN (BUSINESS MANAGER)
(770) 426-0827
Entity
Organization
Contact information
Practice address
945 CHURCH STREET EXT NE STE B, MARIETTA, GA 30060-7293
(770) 426-0827
(770) 426-9534
Mailing address
PO BOX 162406, ATLANTA, GA 30321-2406
(770) 426-0827
(770) 426-9534
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
11D0645784
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
434544295A
—
GA
01
—
52023957
BCBS
GA
Enumeration date
10/11/2006
Last updated
12/30/2010
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