Organization
MALCOLM P. DULOCK, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATTI HERRICK (BUSINESS MANAGER)
(678) 456-8200
Entity
Organization
Contact information
Practice address
319 CANTON RD, CUMMING, GA 30040-2213
(678) 456-8200
(678) 456-8201
Mailing address
319 CANTON RD, CUMMING, GA 30040-2213
(678) 456-8200
(678) 456-8201
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
013265
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922198647
INDIVIDUAL NPI
GA
01
—
GRP7624
MEDICARE
GA
Enumeration date
06/13/2007
Last updated
12/04/2012
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