Organization
ATLANTA CENTER FOR DERMATOLOGIC DISEASES PC
Active
Other names
Drs D Levine J Silyerstein M Fisher M Weil K Ellner
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA REINER (BOOKKEEPING INSURANCE)
(770) 751-1433
Entity
Organization
Contact information
Practice address
1265 UPPER HEMBREE RD, STE 100, ROSWELL, GA 30076-1143
(770) 751-1433
(770) 751-7410
Mailing address
1265 UPPER HEMBREE RD, STE 100, ROSWELL, GA 30076-1143
(770) 751-1433
(770) 751-7410
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
027080
GA
207N00000X
Dermatology Physician
032377
GA
207N00000X
Dermatology Physician
Primary
032990
GA
207N00000X
Dermatology Physician
034135
GA
207N00000X
Dermatology Physician
044141
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0306784
HMO HEALTH FIRST
—
01
—
045942
FAMILY PLUS
—
01
—
070004931
RR MEDICARE
—
01
—
077541037
CHAMPUS
—
01
—
104004
HMO PARTNERS
—
01
—
1751
HMO GEORGIA NETWORK
—
01
—
237691
STATE OF GEORGIA
—
01
—
472244
AETNA US HEALTH CARE
—
01
—
CM0095
RR MEDICARE
—
01
—
D45942
PRUCARE SELECT
—
Enumeration date
04/10/2006
Last updated
12/17/2012
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