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Individual

DINA FORSTHOFFER DLUGOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
3400 MCCLURE BRIDGE RD, B201, DULUTH, GA 30096-6675
(678) 957-8801
(678) 957-8804
Mailing address
PO BOX 3460, DULUTH, GA 30096-0059
(678) 957-8801
(678) 957-8804

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
003394
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
754463940A
GA
Enumeration date
11/16/2005
Last updated
02/03/2010
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