| NPI | 1962767954 |
|---|---|
| Doing Business As | DERMATOLOGY AFFILIATES EAST COBB |
| Entity Type | Organization |
| Authorized Contact | VIRGINIA RUTLEDGE FORNEY President/Owner 404-816-7900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 174400000X Specialist |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2012-07-06 |