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Individual

DAMON ROBERT DENZIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
61 WHITCHER ST NE, SUITE 4100, MARIETTA, GA 30060-1176
(770) 590-4180
(770) 590-4187
Mailing address
872 DEVONWOOD TRL NW, MARIETTA, GA 30064-5440
(678) 687-0229

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003577
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100002309A
GA
Enumeration date
11/08/2006
Last updated
11/06/2019
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