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Individual

BRITTAINY L DARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-7563
Mailing address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-7563

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
64918
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
581397572
TAX ID #
01
581799397
MATERNAL GYNERATIONS PC
GA
05
997395956A
GA
Enumeration date
08/06/2010
Last updated
09/21/2021
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