| NPI | 1790989291 |
|---|---|
| Other Name | OCONEE DERMATOPATHOLOGY |
| Entity Type | Organization |
| Authorized Contact | STELLA MARIES BULENGO Owner 706-769-7546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: GA 050931) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: GA 050931) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: GA 050931) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |