MEDICARE: FINAN DERMATOPATHOLOGY LABORATORY, P.C.

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
1	291U00000X	Clinical Medical Laboratory	060-201	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CN1953	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497755649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FINAN DERMATOPATHOLOGY LABORATORY, P.C.

Provider Business Mailing Address
First Line	:	1200 LAKE HEARN DRIVE
Second Line	:	SUITE 300
City	:	ATLANTA
State	:	GA
Zip	:	30328-4408
Country	:	US
Telephone Number	:	404-851-1766
Fax Number	:	404-851-1767

Provider Business Practice Location Address
First Line	:	1200 LAKE HEARN DRIVE
Second Line	:	SUITE 300
City	:	ATLANTA
State	:	GA
Zip	:	30328-4408
Country	:	US
Telephone Number	:	404-851-1766
Fax Number	:	404-851-1767

Authorized Official
Title or Position	:	LABORATORY DIRECTOR
Name	:	MARIAN C. FINAN
Credential	:	M.D.
Telephone Number	:	404-851-1766

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	03/23/2016

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