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BAUCOM & MINA DERM SURGERY LLC NPI 1245780980


NPI Information

NPI: 1245780980
Provider Name: BAUCOM & MINA DERM SURGERY, LLC
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 11D0906008

Address:
5555 PEACHTREE DUNWOODY RD
SUITE 206
ATLANTA, GA
ZIP 30342
Phone: (404) 844-0496
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BAUCOM & MINA DERM SURGERY, LLC is a mohs-micrographic surgery dermatology in Atlanta, GA. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. BAUCOM & MINA DERM SURGERY, LLC NPI is 1245780980. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5555 PEACHTREE DUNWOODY RD
SUITE 206
ATLANTA, GA
ZIP 30342-703
Phone: (404) 844-0496
Fax: (404) 844-0499

The provider's authorized official is Mary Alice Mina .
The authorized official title is Owner and has the following contact phone number (404) 844-0496.

The CLIA number assigned to this NPI record is 11D0906008 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/6/2016 and was last updated on 12/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryGEORGIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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