Healthcare Provider Details

I. General information

NPI: 1730234238
Provider Name (Legal Business Name): NORTH FULTON NEUROLOGY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 DAHLONEGA STREET SUITE 100
CUMMING GA
30040
US

IV. Provider business mailing address

210 DAHLONEGA STREET SUITE 100
CUMMING GA
30040
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-1589
  • Fax: 786-807-8819
Mailing address:
  • Phone: 770-751-1589
  • Fax: 786-807-8819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: BERNARD DREXINGER JR.
Title or Position: OWNER
Credential: M.D.
Phone: 770-366-9244