Individual
WAYNE L BAKOTIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
6240 SHILOH RD, ALPHARETTA, GA 30005-8347
(855) 422-5628
(205) 579-9387
Mailing address
6240 SHILOH RD, ALPHARETTA, GA 30005-8347
(855) 422-5628
(205) 579-9387
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
051017
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
075954118A
—
GA
Enumeration date
04/10/2006
Last updated
12/15/2022
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