Organization
DEKALB NEUROLOGY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY MABE (OFFICE MANAGER)
(404) 508-4008
Entity
Organization
Contact information
Practice address
2665 N DECATUR RD, SUITE 540, DECATUR, GA 30033-6149
(404) 508-4008
(404) 508-4009
Mailing address
2665 N DECATUR RD, SUITE 540, DECATUR, GA 30033-6149
(404) 508-4008
(404) 508-4009
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
055713
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13BDDXX
—
GA
Enumeration date
04/18/2012
Last updated
04/18/2012
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