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General NPI Number Information
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NPI Number | 1821683616
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Entity Type | Organization
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Legal Business Name | SPECTRUM DERMATOLOGY OF ATLANTA
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 1725 WINDWARD CONCOURSE STE 120
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City | ALPHARETTA
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State | GA
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Zip | 30005-3971
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Country | US
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Telephone | 470-731-8010
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Fax | 470-731-8005
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Provider Business Mailing Address
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Address Line | 1725 WINDWARD CONCOURSE STE 120
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City | ALPHARETTA
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State | GA
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Zip | 30005-3971
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Country | US
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Telephone | 470-731-8010
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Fax | 470-731-8005
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Authorized Official
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Title or Position | OWNER
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Name | EMMA J MURAD
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Credential | MD
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Telephone | 470-731-8009
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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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