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General NPI Number Information
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NPI Number | 1538396577
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Entity Type | Organization
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Legal Business Name | CENTER FOR DERMATOLOGY, LLC
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 721 WELLNESS WAY STE 210
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3304
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Country | US
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Telephone | 770-682-2500
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Fax | 770-682-2014
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Provider Business Mailing Address
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Address Line | 721 WELLNESS WAY STE 210
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-3304
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Country | US
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Telephone | 770-682-2500
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Fax | 770-682-2014
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. ABDUL HAFEEZ
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Credential | M.D.
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Telephone | 678-476-5228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 047327
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License Number State | GA
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