DIAGNOSTIC DERMATOPATHOLOGY (NPI# 1770958092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770958092 |
| Entity Type | Organization |
| Organization Name | DIAGNOSTIC DERMATOPATHOLOGY |
| Other Organization Name | DIAGNOSTIC DERMATOPATHOLOGY ASSOCIATES |
| Practice Address |
2101 Brookstone Centre Pkwy Ste 300 Columbus GA 31904-9254 |
| Practice Telephone | 7062561133 |
| Practice Fax Number | 7062561136 |
| Mailing Telephone | 7062561133 |
| Mailing Fax Number | 7062561136 |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | LIAQAT ALI (OWNER) |
| Authorized Official Telephone | 7062561133 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 74802 | GA | Allopathic & Osteopathic Physicians |
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
74802 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003171345A | 05 |
| Other Name | Type Code |
|---|---|
| Diagnostic Dermatopathology Associates | Doing Business As Name - Organization |
| Street Address |
2101 BROOKSTONE CENTRE PKWY STE 300 |
| City | COLUMBUS |
| State | GA |
| Zip Code | 31904-9254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821641457 | At Home Palliative Care, LLC | Nursing Care | 114 Enterprise Ct, Suite B, Columbus, GA 31904 | 2019-07-23 |
| 1285191049 | Shandra Ladell Grimes | Nurse Practitioner | 2300 Manchester Expwy St Francis Hospital, Suite C-001, Columbus, GA 31904 | 2019-02-27 |
| 1881161529 | Lesley Kathleen Simmons | Massage Therapist | 5402 15th Ave, Columbus, GA 31904 | 2018-10-31 |
| 1184190662 | Alphonsa Joseph | Nurse Practitioner | 2430 Brookstone Centre Parkway, Columbus, Georgia 31904, Columbus, GA 31904 | 2018-10-22 |
| 1568942704 | William Pearce Massey | Social Worker | 8851-1 Moore Road, Columbus, GA 31904 | 2018-08-17 |
| 1033696372 | Marlise V. Gray | Counselor | 2013 Devonshire Dr. Suite 115, Columbus, GA 31904 | 2018-07-19 |
| 1710418173 | Amanda Barnette Pruett | Behavioral Analyst | 200 Brookstone Centre Pkwy Bldg 200, Columbus, GA 31904 | 2017-03-27 |
| 1750833232 | Carrie Leigh Whitehead | Nurse Practitioner | 6228 Bradley Park Dr. Suite A, Columbus, GA 31904 | 2016-10-31 |
| 1609323369 | Shomika Lasha Battle | Registered Nurse | 2101 North Avenue, Columbus, GA 31904 | 2016-09-09 |
| 1952759219 | Peaceful River Home Care Agency | In Home Supportive Care | 738 Rudgate Road, Columbus, GA 31904 | 2016-05-27 |
| Find all providers in zip 31904 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114097623 | Mary Jo Kendrick | Dermatology | 3555 Olentangy River Rd, Suite 4000, Columbus, OH 43214-3912 | 2006-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285613307 | Robert W Wetherington | Dermatology | 2000 Lake Park Dr Se, Smyrna, GA 30080-7611 | 2006-01-17 |
| 1467431940 | Narayan S Naik | Dermatology | 1200 Lake Hearn Dr Ne, Suite300, Atlanta, GA 30319-1415 | 2006-01-12 |
| 1518967918 | Marian C. Finan | Dermatology | 1200 Lake Hearn Drive, Suite 300, Atlanta, GA 30319 | 2005-07-28 |
| 1396243630 | Bakotic Pathology Associates, LLC | Dermatology | 6240 Shiloh Rd, Alpharetta, GA 30005-8347 | 2018-01-31 |
| 1366862203 | Parisa Mansoori | Dermatology | 1901 Phoenix Blvd Ste 210, Atlanta, GA 30349 | 2014-04-18 |
| 1841632783 | Dermpath and Derm Consultants | Dermatology | 1428 Scott Blvd, Decatur, GA 30030-1424 | 2013-07-19 |
| 1689019184 | Abha Soni | Dermatology | 2000 Lake Park Dr Se, Smyrna, GA 30080-7611 | 2013-05-09 |
| 1053565580 | Johns Creek Dermatology and Family Medicine, P.C. | Dermatology | 6300 Hospital Pkwy, Ste 100, Johns Creek, GA 30097 | 2008-11-11 |
| 1679751978 | Zlatan Oruc | Dermatology | 1777 Montreal Cir, Tucker, GA 30084-6802 | 2008-02-08 |
| 1780803098 | Jill Buckthal-mccuin | Dermatology | 1000 Cowles Clinc Way, Aspen Cottages, Greensboro, GA 30642-5285 | 2007-04-25 |
| Find all providers with the same taxonomy | ||||
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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.