Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 022067 | GA |
NPI | 1063700672 |
---|---|
Provider Name | Dr. Dexter Terrence Todmann |
First Address | Atlanta, GA 30345-3154 |
Second Address | Atlanta, GA 30345-3154 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2011 |
Last Update Date | 29/02/2012 |