Individual
DR. LEENA DUTTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
541 441 HISTORIC HWY N, DEMOREST, GA 30535-4528
(770) 219-9179
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
043034
GA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
43034
GA
208M00000X
Hospitalist Physician
Primary
43034
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000894231A
—
GA
Enumeration date
05/31/2006
Last updated
04/14/2025
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