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NPI Code Detail

MEDICARE: FAUSTINE LUU DINH D.O.

MEDICARE: FAUSTINE LUU DINH D.O.
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
1207R00000XInternal Medicine PhysicianLL36700SC
2207R00000XInternal Medicine Physician077724GA

General Provider Information

NPI Number : 1922411537
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAUSTINE LUU DINH D.O.
Provider Business Mailing Address
First Line : PO BOX 742616
Second Line :
City : ATLANTA
State : GA
Zip : 30374-2616
Country : US
Telephone Number : 770-219-8420
Fax Number :
Provider Business Practice Location Address
First Line : 1515 RIVER PL STE 200
Second Line :
City : BRASELTON
State : GA
Zip : 30517-5603
Country : US
Telephone Number : 770-848-6140
Fax Number : 770-848-6141
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2014
Last Update Date : 01/29/2021

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Directions to “ FAUSTINE LUU DINH D.O.” Practice Location

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