Individual provider · NPI-1

Tanya Michelle Dewoody, P.A-C

Physician Assistant · Lithonia, GA

NPI number1235173469
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1235173469
Entity type
Individual (NPI-1)
Name
Tanya Michelle Dewoody
Credential
P.A-C
Sex
Female
Sole proprietor
No
Enumeration date
Jun 16, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant003625GAYes

Practice location

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996

Phone 404-501-8700

Mailing address

2100 Powell Str
Ste 920
Emeryville, CA 94608-1803

Phone 510-350-2777

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