Organization
SUPER DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIONE MARCUS SUPER MD (OWNER)
(770) 285-3533
Entity
Organization
Contact information
Practice address
1364 WELLBROOK CIR NE, CONYERS, GA 30012-3872
(770) 285-3533
Mailing address
1351 AUDUBON CT SW, ATLANTA, GA 30311-2471
(706) 840-4554
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
60121
GA
Other
Enumeration date
02/03/2018
Last updated
02/03/2018
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