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General NPI Number Information
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NPI Number | 1023080561
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Entity Type | Individual
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Provider Name | ADAR BERGHOFF MD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 12/10/2014
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Provider Practice Location Address
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Address Line | 875 JOHNSON FERRY RD SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30342-1418
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Country | US
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Telephone | 404-257-9933
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Fax | 404-257-9931
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Provider Business Mailing Address
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Address Line | 875 JOHNSON FERRY RD SUITE 300
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City | ATLANTA
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State | GA
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Zip | 30342-1418
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Country | US
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Telephone | 404-257-9933
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Fax | 404-257-9931
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD439815
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 65639
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | 65638
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License Number State | GA
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