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General NPI Number Information
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NPI Number | 1245508480
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Entity Type | Individual
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Provider Name | NICOLAS DONALD DUCHEMIN M.D. DABFM
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Gender | Male
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 1240 EAGLES LANDING PKWY STE 110
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5173
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Country | US
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Telephone | 770-389-3855
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Fax | 770-474-8078
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Provider Business Mailing Address
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Address Line | 1240 EAGLES LANDING PKWY STE 110
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5173
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Country | US
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Telephone | 770-389-3855
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Fax | 770-474-8078
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 82008
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License Number State | GA
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