Organization
GWINNETT DERMATOLOGY PC D/B/A GEORGIA DERMATOLOGY PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA RANN (CREDENTIAL)
(770) 972-4845
Entity
Organization
Contact information
Practice address
2383 PATE ST N, SNELLVILLE, GA 30078-3250
(770) 972-4845
(770) 972-0358
Mailing address
2383 PATE ST N, SNELLVILLE, GA 30078-3250
(770) 972-4845
(770) 972-0358
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB2388
RAILROAD MCARE
—
Enumeration date
06/13/2006
Last updated
09/20/2019
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