Organization
PEACHTREE PIEDMONT PATHOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK H DUPUIS MD (PRESIDENT)
(404) 605-3247
Entity
Organization
Contact information
Practice address
1968 PEACHTREE RD NW, PATHOLOGY DEPT, ATLANTA, GA 30309-1281
(800) 288-8325
(404) 609-6645
Mailing address
PO BOX 491028, LAWRENCEVILLE, GA 30049-0053
(404) 605-3247
(404) 609-6645
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030002E
—
GA
Enumeration date
03/21/2006
Last updated
10/06/2022
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