Individual
DEKISHA PENDERGRASS DRAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3885 PRINCETON LAKES WAY, SUITE 302, ATLANTA, GA 30331
(404) 629-1880
(404) 629-1935
Mailing address
6279 VININGS VINTAGE DR, MABLETON, GA 30126-7202
(404) 394-6155
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
053016
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118918947B
—
GA
Enumeration date
10/04/2006
Last updated
09/08/2011
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