DR. MARK ALAN CHASTAIN (NPI# 1790756138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790756138 |
| Entity Type | Individual |
| Full Name | DR. MARK ALAN CHASTAIN |
| Credential | MD |
| Practice Address |
835 Cogburn Ave Nw Suite 100 Marietta GA 30060-1031 |
| Practice Telephone | 7704225557 |
| Practice Fax Number | 7704225456 |
| Mailing Telephone | 7704225557 |
| Mailing Fax Number | 7704225456 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 048995 | GA | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
048995 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 339883816A | 05 | |
| GA | RAILROAD MEDICARE | P00086676 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124182266 | Mark A Chastain | Pharmacist | 202 Governors Dr Se, Huntsville, AL 35801-2745 | 2006-12-21 |
| Street Address |
835 COGBURN AVE NW SUITE 100 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235559378 | Skin Cancer Specialists Surgery Center, LLC | Clinic/Center | 835 Cogburn Ave Nw, Suite 200, Marietta, GA 30060-1031 | 2014-04-16 |
| 1518207950 | Ashley M Ades | Physician Assistant | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1001 | 2013-02-21 |
| 1215220454 | Matthew Preston Hughes | Dermatology | 835 Cogburn Ave Nw, Suite 250, Marietta, GA 30060-1001 | 2011-05-20 |
| 1518262450 | Alexandra Palgon | Physician Assistant | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1031 | 2011-01-25 |
| 1700060159 | Bridget M Sroka | Physician Assistant | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1031 | 2007-12-20 |
| 1649477035 | Anita Kanithahalli Shetty | Dermatology | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1031 | 2007-06-28 |
| 1407957087 | Carolyn M Sims | Physician Assistant | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1031 | 2006-09-26 |
| 1114022167 | Skin Cancer Specialists P C | Dermatology | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1031 | 2006-09-14 |
| 1215908652 | Jennifer Louise Buckley | Dermatology | 835 Cogburn Ave Nw, Suite 100, Marietta, GA 30060-1031 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| 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 |
|---|---|---|---|---|
| 1720686058 | Worldwide Medical Healthcare Inc | Dermatology | 790 Church St Ne Ste 300, Marietta, GA 30060-8902 | 2020-10-09 |
| 1346700127 | Gerald Chotiner | Dermatology | 2887 Gant Qtrs. Circle, Marietta, GA 30068-3719 | 2019-03-20 |
| 1790791465 | Debra J Atkins | Dermatology | 1232 Johnson Ferry Rd, Marietta, GA 30068-2776 | 2006-08-01 |
| 1164442562 | Jim D Adkins | Dermatology | 111 Marble Mill Road, Marietta, GA 30060-1047 | 2006-07-20 |
| 1114985108 | Jennifer L Jones | Dermatology | 835 Cogburn Avenue, Suite 100, Marietta, GA 30060-1008 | 2006-05-02 |
| 1366428146 | Candance Kimbrough-green | Dermatology | 4800 Olde Towne Pkwy Ste 250, Marietta, GA 30068-4428 | 2005-12-22 |
| 1669462610 | Mitra Mofid | Dermatology | 2550 Windy Hill Road Se, Suite 103, Marietta, GA 30067-8607 | 2005-10-21 |
| 1447851357 | Dermatology and Surgery Specialists of North Atlanta PC | Dermatology | 4800 Olde Towne Pkwy Ste 250, Marietta, GA 30068-4428 | 2020-11-06 |
| 1356861975 | Anissa Mansoori | Dermatology | 141 Lacy St Nw Ste 200, Marietta, GA 30060-1118 | 2017-06-24 |
| 1306232608 | Hailey F Rouhana | Dermatology | 835 Cogburn Avenue, Suite 100, Marietta, GA 30060-1008 | 2015-04-13 |
| Find all providers in MARIETTA | ||||
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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.