Individual
DR. DEANNA MULLIS DEL MAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1270 FRIENDSHIP RD, BRASELTON, GA 30517-5630
(770) 535-0191
(770) 535-0916
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
068502
GA
207R00000X
Internal Medicine Physician
68502
GA
207R00000X
Internal Medicine Physician
ME102490
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003158173B
—
GA
Enumeration date
05/25/2007
Last updated
04/14/2022
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