National Provider Identifier Database

TARA DERMATOLOGY CENTER PC
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

TARA DERMATOLOGY CENTER PC
191 MEDICAL BLVD
STOCKBRIDGE, GA30281-5083
Phone: 770-991-1000
Fax:
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for TARA DERMATOLOGY CENTER PC

NPI Number 1699892380
Legal business name
LBN
TARA DERMATOLOGY CENTER PC
Authorized official VINCENT PENG - (PHYSICIAN)
Entity Organization
Organization subpart No
Enumeration date 03/26/2007
Last updated 03/26/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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