Physician Compare National (NPI:1659409043)

HEALTHCARE PROVIDER: DENISE CHERYL DE VERANEZ MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659409043
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385812445
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110718000245
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DEVERANEZ
	Individual professional last name
Provider First Name	DENISE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	HOWARD UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1100 EAGLES LANDING PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	STOCKBRIDGE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	302819105
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4704882381
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110191
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIEDMONT HENRY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y