DERMATOLOGY AFFILIATES LLC NPI 1730244872

NPI Information

  • NPI: 1730244872
  • Provider Name: DERMATOLOGY AFFILIATES, LLC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • CLIA Number: 11D2309942
  • Address: 3131 MAPLE DR NE
    SUITE 102
    ATLANTA, GA
    ZIP 30305
  • Phone: (404) 816-7900

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NPI Details

DERMATOLOGY AFFILIATES, 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 AFFILIATES, LLC NPI is 1730244872. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3131 MAPLE DR NE
SUITE 102
ATLANTA, GA
ZIP 30305
Phone: (404) 816-7900
Fax: (404) 816-7929

The provider's authorized official is Virginia Rutledge Forney .
The authorized official title is Director/officer and has the following contact phone number (404) 816-7900.

The CLIA number assigned to this NPI record is 11D2309942 - other - clinical research with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 8/29/2018.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist044218GEORGIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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