National Provider Identifier Database

MEDICAL DERMATOLOGY SPECIALISTSPC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

MEDICAL DERMATOLOGY SPECIALISTS,PC
5730 GLENRIDGE DR
SUITE T-100
SANDY SPRINGS, GA30328-6141
Phone: 404-939-9220
Fax: 404-939-9221
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for MEDICAL DERMATOLOGY SPECIALISTS,PC

NPI Number 1134544679
Legal business name
LBN
MEDICAL DERMATOLOGY SPECIALISTS,PC
Authorized official JAMIE WEISMAN - (PHYSICIAN/OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/20/2014
Last updated 08/31/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 50088
  • GA Other: 07BBSST MEDICARE ID
  • GA Other: 202I075875 MEDICARE PTAN
  • GA Other: 070016848 MEDICARE RAILROAD

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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