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General NPI Number Information
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NPI Number | 1891971149
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Entity Type | Individual
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Provider Name | ANDREW CULLEN DENNISON M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 2020 PEACHTREE RD NW SHEPHERD CENTER
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City | ATLANTA
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State | GA
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Zip | 30309-1426
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Country | US
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Telephone | 404-350-7353
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Fax | 404-350-7381
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Provider Business Mailing Address
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Address Line | 2020 PEACHTREE RD NW SHEPHERD CENTER
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City | ATLANTA
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State | GA
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Zip | 30309-1426
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Country | US
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Telephone | 404-350-7353
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Fax | 404-350-7381
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | BP10623180
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2008-00384
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 062676
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License Number State | GA
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