Healthcare Provider Details

I. General information

NPI: 1407849888
Provider Name (Legal Business Name): BERNARD R DREXINGER JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 DAHLONEGA ST STE 100
CUMMING GA
30040-3158
US

IV. Provider business mailing address

210 DAHLONEGA ST STE 100
CUMMING GA
30040-3158
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-1589
  • Fax: 678-807-8819
Mailing address:
  • Phone: 770-751-1589
  • Fax: 678-807-8819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number32555
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number73161
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number032555
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: