VINCENT T PENG (NPI# 1245302165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245302165 |
| Entity Type | Individual |
| Full Name | VINCENT T PENG |
| Credential | MD |
| Practice Address |
191 Medical Boulevard Stockbridge GA 30281 |
| Mailing Address |
191 Medical Blvd Stockbridge GA 30281 |
| Practice Telephone | 7709911000 |
| Practice Fax Number | 7709912088 |
| Mailing Telephone | 7709911000 |
| Mailing Fax Number | 7709912088 |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2007-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 014652 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | BCBSGA PROVIDER NUMBER | 1245302165 | 01 |
| Street Address |
191 MEDICAL BOULEVARD |
| City | STOCKBRIDGE |
| State | GA |
| Zip Code | 30281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039095 | Colette Alls | Social Worker | 447 Lakeshore Dr, Stockbridge, GA 30281 | 2020-09-24 |
| 1982216800 | Pediatric and Family Behavioral Health of Georgia | Counselor | 1004 Ulster Court, Stockbridge, GA 30281 | 2020-08-21 |
| 1518577659 | Qunique Taveka Toxey | Behavior Technician | 115 N Park Trail, Suite 123, Stockbridge, GA 30281 | 2020-08-04 |
| 1497377675 | Melanie Harvey | Pharmacist | 4467 North Henry Boulevard, Stockbridge, GA 30281 | 2020-05-11 |
| 1114550571 | Cecile Maria Dunkley Layne | Counselor | 255 Corporte Drive, Stockbridge, GA 30281 | 2020-02-13 |
| 1306407143 | Palliative Care of Georgia. LLC | Home Health | 275 Corporate Center Court Ste C, Stockbridge, GA 30281 | 2019-06-24 |
| 1154883791 | Aaliyah Nura Fardan-alexander | Nurse's Aide | 105 Singletree, Stockbridge, GA 30281 | 2019-04-02 |
| 1306306261 | Prosthetic Care, Inc. | Prosthetic/Orthotic Supplier | 150 County Club Drive, Suite 200, Stockbridge, GA 30281 | 2019-03-25 |
| 1356814172 | Kristina Louissaint | Nurse Practitioner | 650 Country Club Dr, Stockbridge, GA 30281 | 2019-01-03 |
| 1942789284 | Cameren Barnes | Physical Therapist | 5473 N Henry Blvd, Stockbridge, GA 30281 | 2018-08-08 |
| Find all providers in zip 30281 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932563640 | National Healthcare Center LLC | Dermatology | 135 Eagles Walk Ste 100, Stockbridge, GA 30281-7205 | 2016-04-08 |
| 1598120271 | Eagles Landing Medical Center | Dermatology | 1215 Eagles Landing Pkwy Ste 205, Stockbridge, GA 30281-7280 | 2015-12-22 |
| 1922494483 | Brenda Maria Morales-pico | Dermatology | 210 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2015-04-11 |
| 1366700544 | Bella Dermatology | Dermatology | 175 Country Club Dr, Stockbridge, GA 30281-9054 | 2012-04-25 |
| 1427201771 | Dr. Terry L. Sharpe M.d. PC | Dermatology | 1365 Rock Quarry Rd Ste 300, Stockbridge, GA 30281-5024 | 2008-10-30 |
| 1285784439 | Terry Lynn Sharpe | Dermatology | 1215 Eagles Landing Pkwy, Suite 210, Stockbridge, GA 30281-7279 | 2007-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720686058 | Worldwide Medical Healthcare Inc | Dermatology | 790 Church St Ne Ste 300, Marietta, GA 30060-8902 | 2020-10-09 |
| 1972142891 | Worldwide Medical Distributor, LLC | Dermatology | 3780 Old Norcross Rd Ste 103, Duluth, GA 30096-1762 | 2019-12-23 |
| 1932762218 | Laura Quinn Biehle | Dermatology | 5730 Glenridge Dr Ste T100, Atlanta, GA 30328-5747 | 2019-04-22 |
| 1003479254 | Kiley Katherine Fagan | Dermatology | 775 Aronson Lake Ct, Roswell, GA 30075-7172 | 2019-04-15 |
| 1346700127 | Gerald Chotiner | Dermatology | 2887 Gant Qtrs. Circle, Marietta, GA 30068-3719 | 2019-03-20 |
| 1205308616 | Belle Lumiere Cosmetics LLC | Dermatology | 753 Old Norcross Road, Lawrenceville, GA 30046 | 2018-12-24 |
| 1154890564 | Sidney Adele Brown-caggiano | Dermatology | 4645 Timber Ridge Dr Ste 100, Douglasville, GA 30135-7542 | 2018-11-14 |
| 1194209163 | Live Oak Dermatology | Dermatology | 135 Norcross St # 8, Roswell, GA 30075-3867 | 2018-09-17 |
| 1942780994 | Skyn Clinic & Apothecary | Dermatology | 1150 Peachtree Industrial Blvd Ste 165, Suwanee, GA 30024-1903 | 2018-08-20 |
| 1649750688 | Zola Nemorin | Dermatology | 1500 Peachtree Industrial Blvd Ste 165, Suwanee, GA 30024-8490 | 2018-08-20 |
| Find all providers with the same taxonomy | ||||
| City | STOCKBRIDGE |
| Zip Code | 30281 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.