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General NPI Number Information
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NPI Number | 1245354299
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Entity Type | Individual
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Provider Name | DIANE ZALUTSKY ALEXANDER M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5445 MERIDIAN MARKS RD NE SUITE 390
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City | ATLANTA
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State | GA
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Zip | 30342-4763
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Country | US
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Telephone | 404-851-1998
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Fax | 404-531-4039
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Provider Business Mailing Address
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Address Line | 5445 MERIDIAN MARKS RD NE SUITE 390
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City | ATLANTA
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State | GA
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Zip | 30342-4763
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Country | US
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Telephone | 404-851-1998
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Fax | 404-531-4039
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 034996
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License Number State | GA
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