Individual provider · NPI-1

Rae Riley Dewoody, P.A-C

Physician Assistant · Lithonia, GA

NPI number1942244157
StatusActive
Last updated in NPPESJan 7, 2022

Details

NPI
1942244157
Entity type
Individual (NPI-1)
Name
Rae Riley Dewoody
Credential
P.A-C
Sex
Female
Sole proprietor
No
Enumeration date
Jun 16, 2006
Last updated
Jan 7, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant002645CAYes

Practice location

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996

Phone 404-501-8700

Mailing address

2100 Powell St
Ste 920
Emeryville, CA 94608-1826

Phone 510-350-2777

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