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NPI Code Detail

MEDICARE: FELICITY M. WARREN M.D.

MEDICARE: FELICITY M. WARREN 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
1207N00000XDermatology Physician034978GA
2174400000XSpecialist034978GA

General Provider Information

NPI Number : 1295727527
Entity Type Code : Individual
Provider Name (Legal Business Name) : FELICITY M. WARREN M.D.
Provider Business Mailing Address
First Line : 3993 LAWRENCEVILLE HWY NW STE 110
Second Line :
City : LILBURN
State : GA
Zip : 30047-2831
Country : US
Telephone Number : 770-852-5552
Fax Number : 770-852-5553
Provider Business Practice Location Address
First Line : 3993 LAWRENCEVILLE HWY NW STE 110
Second Line :
City : LILBURN
State : GA
Zip : 30047-2831
Country : US
Telephone Number : 770-852-5552
Fax Number : 770-852-5553
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 07/19/2019

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