Organization
HILLANDALE INTERNAL MEDICINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALLACE DUNCAN M.D. (CEO)
(770) 987-8400
Entity
Organization
Contact information
Practice address
5900 HILLANDALE DR, ANNEX E, LITHONIA, GA 30058-3802
(770) 987-8400
(770) 987-8494
Mailing address
5900 HILLANDALE DR, ANNEX E, LITHONIA, GA 30058-3802
(770) 987-8400
(770) 987-8494
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041109
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00687893G
—
GA
Enumeration date
04/05/2011
Last updated
04/05/2011
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