| Dekalb Neurology Group, Llc | |
|
2665 N Decatur Rd Suite 540 Decatur GA 30033-6149 | |
| (404) 508-4008 | |
| (404) 508-4009 |
| Full Name | Dekalb Neurology Group, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2665 N Decatur Rd, Decatur, Georgia |
| Authorized Official Name and Position | Amy Mabe (OFFICE MANAGER) |
| Authorized Official Contact | 4045084008 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dekalb Neurology Group, Llc 2665 N Decatur Rd Suite 540 Decatur GA 30033-6149 Ph: (404) 508-4008 | Dekalb Neurology Group, Llc 2665 N Decatur Rd Suite 540 Decatur GA 30033-6149 Ph: (404) 508-4008 |
| NPI Number | 1649537416 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 04/18/2012 |
| Medicare PECOS PAC ID | 3577725589 |
|---|---|
| Medicare Enrollment ID | O20120508000347 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649537416 | NPI | - | NPPES |
| 13BDDXX | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 055713 (Georgia) | Primary |
| Provider Name | David A Olson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598829830 PECOS PAC ID: 9931373255 Enrollment ID: I20111128000119 |
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