Individual
DR. DERRICK C PAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3225 CUMBERLAND BLVD SE, SUITE 900, ATLANTA, GA 30339-6407
(404) 351-2220
(404) 352-5392
Mailing address
3225 CUMBERLAND BLVD SE, SUITE 900, ATLANTA, GA 30339-6407
(404) 351-2220
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
076620
GA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
Primary
076620
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00312691B
—
GA
01
—
202I189735
MEDICARE PTAN
GA
Enumeration date
11/05/2008
Last updated
03/05/2019
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