DIVINE DERMATOLOGY & AESTHETICS LLC (NPI# 1730682725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730682725 |
| Entity Type | Organization |
| Organization Name | DIVINE DERMATOLOGY & AESTHETICS LLC |
| Practice Address |
1039 Grant St Se Ste A-11 Atlanta GA 30315-2014 |
| Mailing Address |
830 Glenwood Ave Se Ste 510-209 Atlanta GA 30316-1966 |
| Practice Telephone | 6785897546 |
| Practice Fax Number | 6785897500 |
| Mailing Telephone | 6785897546 |
| Mailing Fax Number | 6785897500 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-03-15 |
| Authorized Official Name | TUNISIA F. CORNELIUS (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6785897546 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | GA | Allopathic & Osteopathic Physicians |
| Street Address |
1039 GRANT ST SE STE A-11 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30315-2014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181341 | Erin Cole | Specialist/Technologist | Lakewood Ave Se, Atlanta, GA 30315 | 2018-10-25 |
| 1942701081 | Julie Crocker | Dental Hygienist | 1046 Ridge Ave. Sw, Atlanta, GA 30315 | 2018-02-23 |
| 1457695850 | Dominica Aquino Morales-gibson | Physical Therapist | 2850 Springdale Road Sw, Atlanta, GA 30315 | 2012-11-26 |
| 1912264813 | Maxwell Uhakheme | Internal Medicine | 6875 Douglas Blvd, Suite A, Kaiser Permanente Douglasville Medical Center, Douglasville, GA 30315 | 2012-04-16 |
| 1427329093 | Sulonda Smith | Counselor | 34 Atlanta Ave. Se, Hank Aaron Blvd, Atlanta, GA 30315 | 2012-01-13 |
| 1407152507 | Gerald Leroy Griffin | Pharmacist | 520 Boulevard, Atlanta, GA 30315 | 2011-02-07 |
| 1356512180 | Chandra Blakely | Counselor | 215 Lakewood Way, Suite 205, Atlanta, GA 30315 | 2008-03-19 |
| 1104043967 | Alvin H. Clair, M.d.p.c. | Dermatology | 777 Cleveland Ave.,sw Ste.500, Atlanta, GA 30315 | 2007-04-20 |
| 1396877742 | Scott M Russell | Speech-Language Pathologist | 1364 Clifton Road, Atlanta, GA 30315 | 2007-03-12 |
| 1043356280 | South Fulton Health Center | Public Health or Welfare | 1225 Capitol Avenue, Se, Atlanta, GA 30315 | 2007-01-29 |
| Find all providers in zip 30315 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932762218 | Laura Quinn Biehle | Dermatology | 5730 Glenridge Dr Ste T100, Atlanta, GA 30328-5747 | 2019-04-22 |
| 1366952707 | Chelsie Rogers | Dermatology | 371 E Paces Ferry Rd Ne Ste 825, Atlanta, GA 30305-3292 | 2017-10-11 |
| 1720506231 | O'reilly Comprehensive Dermatology, Inc. | Dermatology | 755 Mount Vernon Hwy., Suite 330, Atlanta, GA 30228 | 2017-09-05 |
| 1356872246 | Tova Rogers | Dermatology | 1525 Clifton Road Suite 105, Atlanta, GA 30322 | 2017-03-23 |
| 1255614855 | Paul Calvin Cronce | Dermatology | 1747 Timberland Rd Ne, Atlanta, GA 30345-4166 | 2011-09-21 |
| 1205123296 | Josh A Hammel | Dermatology | 4360 Chamblee Dunwoody Rd Ste 260, Atlanta, GA 30341 | 2011-06-29 |
| 1093006793 | Seema Panduranga Kini | Dermatology | Emory University Graduate, 1648 Pierce Dr., Atlanta, GA 30322-0001 | 2011-04-28 |
| 1639478464 | Julia Pettersen Neckman | Dermatology | 875 Johnson Fy Rd Ne Ste 300, Atlanta, GA 30342 | 2011-03-18 |
| 1952628471 | Justin Thomas Cheeley | Dermatology | 1525 Clifton Rd Ne Dept Of, Atlanta, GA 30322-1059 | 2010-04-23 |
| 1245404854 | Tunisia Finch Cornelius | Dermatology | 1039 Grant St Se Ste A-11, Atlanta, GA 30315 | 2008-04-15 |
| Find all providers in ATLANTA | ||||
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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.