Individual
DR. GARY DERUSSO II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3950 AUSTELL RD, AUSTELL, GA 30106
(770) 732-3585
(770) 732-3589
Mailing address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(770) 732-3585
(770) 732-3589
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
83581
GA
Other
Enumeration date
04/20/2015
Last updated
09/26/2019
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