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General NPI Number Information
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NPI Number | 1538034129
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Entity Type | Organization
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Legal Business Name | LUXE DERM SPA
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1323 METROPOLITAN PKWY SW
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City | ATLANTA
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State | GA
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Zip | 30310-4441
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Country | US
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Telephone | 678-607-9923
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Fax |
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Provider Business Mailing Address
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Address Line | 830 GLENWOOD AVE SE STE 510-209
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City | ATLANTA
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State | GA
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Zip | 30316-1966
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Country | US
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Telephone | 404-354-0101
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Fax | 678-589-7500
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Authorized Official
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Title or Position | OWNER
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Name | DR. TUNISIA FINCH CORNELIUS
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Credential | MD
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Telephone | 678-607-9923
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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 |
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License Number State |
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