Organization
EPIPHANY DERMATOLOGY OF GEORGIA, LLC
Active
Other names
Epiphany Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
GHEORGHE PUSTA (EXECUTIVE DIRECTOR)
(512) 628-0465
Entity
Organization
Contact information
Practice address
874 LANIER AVE W STE 270, FAYETTEVILLE, GA 30214-7617
(770) 251-5111
Mailing address
7300 RANCH ROAD 2222, BUILDING 1, STE 200, AUSTIN, TX 78730
(512) 628-0465
(512) 233-2711
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
08/31/2006
Last updated
03/19/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us