Dolly Chanta'e Penn, MD, MSCR is a
Preventive Medicine - Public Health & General Preventive Medicine physician based in Canton, Georgia. Dolly Chanta'e Penn is licensed to practice in Georgia (license number 81812) and her current practice location is 111 Mountain Brook Dr Ste 100, Canton, Georgia. She can be reached at her office (for appointments etc.) via phone at
(678) 880-9654.
NPI number for Dolly Chanta'e Penn is 1669609442 and her current mailing address is 6707 Democracy Blvd Suite 800, Bethesda, Maryland. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1669609442.
Physician's Profile
| Full Name | Dolly Chanta'e Penn |
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| Gender | Female |
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| Speciality | Preventive Medicine - Public Health & General Preventive Medicine |
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| Location | 111 Mountain Brook Dr Ste 100, Canton, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1669609442
- Provider Enumeration Date: 06/18/2009
- Last Update Date: 02/25/2025
Medical Identifiers
Medical identifiers for Dolly Chanta'e Penn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669609442 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 81812 (Georgia) | Secondary |
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | D81335 (Maryland) | Secondary |
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 81812 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dolly Chanta'e Penn is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dolly Chanta'e Penn, MD, MSCR
6707 Democracy Blvd Suite 800,
Bethesda, MD 20892-5465
Ph: (301) 496-8676 | Dolly Chanta'e Penn, MD, MSCR
111 Mountain Brook Dr Ste 100,
Canton, GA 30115-9045
Ph: (678) 880-9654 |
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