Mary M Feldman MD LLC
Clinic/Center, Medical Specialty in Carrollton, GA. Organization (NPI-2).
NPI number1699215541
StatusActive
Last updated in NPPESFeb 26, 2017
Details
- NPI
- 1699215541
- Entity type
- Organization (NPI-2)
- Legal business name
- Mary M Feldman MD LLC
- Organization subpart
- No
- Enumeration date
- Feb 26, 2017
- Last updated
- Feb 26, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | 69043 | GA | Yes |
Other names
- Carrollton Dermatology (Doing Business As)
Practice location
100 Professional PlSte 110
Carrollton, GA 30117-3874
Phone 770-834-0818 · Fax 770-834-5098
Mailing address
100 Professional PlSte 110
Carrollton, GA 30117-3874
Phone 770-834-0818 · Fax 770-834-5098
Authorized official
Mary M Feldman
Owner
5042315544
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