Healthcare Provider Details

I. General information

NPI: 1942485511
Provider Name (Legal Business Name): DENISE B. PECHT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2008
Last Update Date: 12/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

771 OLD NORCROSS RD SUITE 305
LAWRENCEVILLE GA
30045-4317
US

IV. Provider business mailing address

771 OLD NORCROSS RD SUITE 305
LAWRENCEVILLE GA
30045-4317
US

V. Phone/Fax

Practice location:
  • Phone: 770-339-4000
  • Fax: 770-339-9037
Mailing address:
  • Phone: 770-339-4000
  • Fax: 770-339-9037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number034436
License Number StateGA

VIII. Authorized Official

Name: DR. DENISE B PECHT
Title or Position: PRESIDENT
Credential: MD
Phone: 770-339-4000