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Individual

PAUL D. MCCLUSKEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
960 JOHNSON FERRY RD NE, SUITE 245, ATLANTA, GA 30342-1631
(404) 499-0111
(404) 499-0114
Mailing address
960 JOHNSON FERRY RD NE, SUITE 245, ATLANTA, GA 30342-1631
(404) 499-0111
(404) 499-0114

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
60773
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP1-0026739
INSTITUTIONAL PERMIT
Enumeration date
06/11/2007
Last updated
11/25/2009
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