Healthcare Provider Details

I. General information

NPI: 1376937037
Provider Name (Legal Business Name): SPELMAN COLLEGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2015
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 SPELMAN LN SW BOX 1683
ATLANTA GA
30314-4395
US

IV. Provider business mailing address

350 SPELMAN LANE BOX 1683
ATLANTA GA
30314
US

V. Phone/Fax

Practice location:
  • Phone: 404-270-5245
  • Fax:
Mailing address:
  • Phone: 404-270-5245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. BRENDA DENISE DALTON
Title or Position: DIRECTOR, STUDENT HEALTH SERVICES
Credential: PHD,MBA,MSN,WHNP-BC
Phone: 404-270-5245