Healthcare Provider Details

I. General information

NPI: 1821522855
Provider Name (Legal Business Name): JUAN-MANUEL DURAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2017
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11315 JOHNS CREEK PKWY STE 100
JOHNS CREEK GA
30097-2645
US

IV. Provider business mailing address

993 JOHNSON FY RD NE
ATLANTA GA
30342-1620
US

V. Phone/Fax

Practice location:
  • Phone: 470-632-8160
  • Fax:
Mailing address:
  • Phone: 404-256-1727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35C.002583
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: