Individual
DYLAN ISAAC MARANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 HOSPITAL BLVD, PATHOLOGY DEPT, ROSWELL, GA 30076-4915
(770) 751-2529
(770) 751-2723
Mailing address
PO BOX 491240, LAWRENCEVILLE, GA 30049
(770) 751-2529
(770) 751-2723
Taxonomy
Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
055129
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
055129
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
565333255A
—
GA
05
—
565333255B
—
GA
05
—
565333255C
—
GA
Enumeration date
04/13/2006
Last updated
07/24/2008
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