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NPI Code Detail

MEDICARE: DR. DEXTER TERRENCE TODMANN M.D.

MEDICARE: DR. DEXTER TERRENCE TODMANN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician22067GA

General Provider Information

NPI Number : 1063700672
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEXTER TERRENCE TODMANN M.D.
Provider Business Mailing Address
First Line : 2200 CENTURY PKWY NE
Second Line : SUITE 600
City : ATLANTA
State : GA
Zip : 30345-3154
Country : US
Telephone Number : 404-633-4838
Fax Number : 404-296-3129
Provider Business Practice Location Address
First Line : 5134 PEACHTREE RD
Second Line :
City : CHAMBLEE
State : GA
Zip : 30341-2724
Country : US
Telephone Number : 678-872-7100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2011
Last Update Date : 11/27/2023

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