DR. WESTON THOMAS WAXWEILER (NPI# 1386936839) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386936839 |
| Entity Type | Individual |
| Full Name | DR. WESTON THOMAS WAXWEILER |
| Credential | M.D. |
| Practice Address |
3850 Pleasant Hill Rd Duluth GA 30096-4807 |
| Practice Telephone | 7708148222 |
| Practice Fax Number | 6782055111 |
| Mailing Telephone | 7708148222 |
| Mailing Fax Number | 6782055111 |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2015-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 073880 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003166483B | 05 | |
| GA | 003166483C | 05 | |
| GA | 003166483D | 05 | |
| GA | 003166483A | 05 | |
| GA | AMERIGROUP | 03277940 | 01 |
| Street Address |
3850 PLEASANT HILL RD |
| City | DULUTH |
| State | GA |
| Zip Code | 30096-4807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427040799 | North Atlanta Dermatology, P.C. | Dermatology | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2005-08-22 |
| 1912390428 | Julia Ro | Physician Assistant | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2015-03-07 |
| 1366781213 | Karly Marie Kincaid Moss | Physician Assistant | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2013-02-12 |
| 1982981155 | Nikki Orciuch Traylor | Physician Assistant | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2011-11-15 |
| 1801930862 | Sara Barr | Physician Assistant | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2007-02-16 |
| 1538235114 | Joan Mary Garramone | Nurse Practitioner | 3850 Pleasant Hill Rd, Suite B, Duluth, GA 30096-4807 | 2006-11-27 |
| 1033151063 | Stephanie Stein Gardner | Specialist | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2006-06-12 |
| 1306890678 | Abhik Damian Dhar | Dermatology | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2006-05-20 |
| 1285627505 | Anjana M Patel | Physician Assistant | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2005-08-23 |
| 1003808361 | Charles Jacob Douchy | Dermatology | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2005-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922615897 | Georgia Eye Optical, LLC | Ophthalmology | 3800 Pleasant Hill Rd Ste 3, Duluth, GA 30096 | 2020-09-25 |
| 1568090868 | Positive Behavior Services, Inc | Behavior Technician | 3765 Crestwood Pkwy Nw, Duluth, GA 30096 | 2020-03-31 |
| 1861031940 | Elizabeth Ashley Edouard | Counselor | 3464 Duluth Hwy 120, Duluth, GA 30096 | 2020-01-06 |
| 1245701044 | Kathryn Irene Vaughn | Social Worker | 3968 Mainsail Court, Duluth, GA 30096 | 2018-12-06 |
| 1083184626 | Aica Orthopedics, P.C. | Orthopaedic Surgery | 3775 Venture Drive Bldg F, Duluth, GA 30096 | 2018-11-27 |
| 1245709799 | Positive Impact Health Centers, Inc. | Pharmacy | 3350 Breckinridge Blvd, Suite 200a, Duluth, GA 30096 | 2018-11-14 |
| 1235611724 | Katherine Winstead Knott | Counselor | 3460 Summit Ridge Parkway, Suite 503, Duluth, GA 30096 | 2018-08-31 |
| 1710467857 | Envision Optics LLC | Optometrist | 1943 Pleasant Hill Rd, Duluth, GA 30096 | 2018-08-17 |
| 1104314202 | Erin Mckernan Scupham | Chiropractor | 3820 Pleasant Hill Rd. Ne, Suite 4, Duluth, GA 30096 | 2018-04-25 |
| 1053839456 | Rogers Bridge Pediatric Therapy, LLC | Clinic/Center | 2845 Summercrest Ln, Duluth, GA 30096 | 2017-09-06 |
| Find all providers in zip 30096 | ||||
| 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 |
|---|---|---|---|---|
| 1972142891 | Worldwide Medical Distributor, LLC | Dermatology | 3780 Old Norcross Rd Ste 103, Duluth, GA 30096-1762 | 2019-12-23 |
| 1407912678 | Jeffrey Neil Samuelson | Dermatology | 1414 Woodland Ave, Duluth, MN 55803-2624 | 2006-12-29 |
| 1427040799 | North Atlanta Dermatology, P.C. | Dermatology | 3850 Pleasant Hill Rd, Duluth, GA 30096-4807 | 2005-08-22 |
| 1689986291 | Michael Marc Wolz | Dermatology | 400 East Third Street, Essentia Health Duluth Clinic, Duluth, MN 55805-1951 | 2010-07-12 |
| 1205013141 | Kristin Hendren Magee | Dermatology | 9900 Medlock Bridge Rd, Duluth, GA 30097-2017 | 2008-01-22 |
| 1457553661 | Heather Joy Buchholz | Dermatology | 920 E 1st St, Ste. 201, Duluth, MN 55805-2201 | 2007-06-01 |
| 1689785875 | John H Strickler Jr. | Dermatology | 3650 Steve Reynolds Boul, Department of Dermatology, Duluth, GA 30096 | 2006-08-31 |
| 1851325393 | Robert Herluf Lund | Dermatology | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-07-10 |
| 1164458162 | Michael Jon Bayer | Dermatology | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-06-23 |
| 1487699807 | Susan Elizabeth Ash | Dermatology | 400 E 3rd St, Duluth, MN 55805-1951 | 2006-06-19 |
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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.