Provider Type Icon

DERMATOLOGY BOUTIQUE LLC NPI 1699800516


NPI Information

NPI: 1699800516
Provider Name: DERMATOLOGY BOUTIQUE LLC

Doing Business As: INTOWN DERMATOLOGY

Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 11D2004072

Address:
550 PEACHTREE ST NE STE 1490
ATLANTA, GA
ZIP 30308
Phone: (404) 523-4223
Get Directions

DERMATOLOGY BOUTIQUE LLC is a specialist in Atlanta, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY BOUTIQUE LLC NPI is 1699800516. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Intown Dermatology.

The provider's business location address is:

550 PEACHTREE ST NE STE 1490
ATLANTA, GA
ZIP 30308-244
Phone: (404) 523-4223

The provider's authorized official is Wakitha A. Griffin .
The authorized official title is Owner and has the following contact phone number (404) 523-4223.

The CLIA number assigned to this NPI record is 11D2004072 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 11/8/2022.


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
1174400000XSpecialist051138GEORGIAYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.