Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 034436 | GA |
NPI | 1043204498 |
---|---|
Provider Name | Denise B Pecht |
First Address | Lawrenceville, GA 30045-3333 |
Second Address | Lawrenceville, GA 30045-3333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 17/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E58276 | (02) | GA |