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General NPI Number Information
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NPI Number | 1992836746
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Entity Type | Organization
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Legal Business Name | DUNWOODY DERMATOLOGY,LLC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 4360 CHAMBLEE DUNWOODY RD SUITE 260
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City | ATLANTA
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State | GA
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Zip | 30341-1049
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Country | US
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Telephone | 770-452-5667
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Fax | 770-452-5677
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Provider Business Mailing Address
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Address Line | 4360 CHAMBLEE DUNWOODY RD SUITE 260
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City | ATLANTA
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State | GA
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Zip | 30341-1049
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Country | US
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Telephone | 770-452-5667
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Fax | 770-452-5677
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. LORI BETH SCHAEN
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Credential | MD
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Telephone | 770-452-5667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 050434
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License Number State | GA
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