Individual
DEDRA J BLALOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PEACHTREE ST, ATLANTA, GA 30308
(404) 686-7431
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 686-7431
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
APRN-NP089049
GA
Other
Enumeration date
10/04/2006
Last updated
10/20/2025
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