| Eamon Dutta, Md Pc | |
|
2150 Peachford Rd Suite A Atlanta GA 30338-6520 | |
| (770) 344-9818 | |
| (770) 458-1596 |
| Full Name | Eamon Dutta, Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2150 Peachford Rd, Atlanta, Georgia |
| Authorized Official Name and Position | Kenneth R Warner (BILLING) |
| Authorized Official Contact | 7704581594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eamon Dutta, Md Pc 2150 Peachford Rd Suite A Atlanta GA 30338-6520 Ph: () - | Eamon Dutta, Md Pc 2150 Peachford Rd Suite A Atlanta GA 30338-6520 Ph: (770) 344-9818 |
| NPI Number | 1629246137 |
|---|---|
| Provider Enumeration Date | 02/19/2008 |
| Last Update Date | 02/19/2008 |
| Medicare PECOS PAC ID | 3375621030 |
|---|---|
| Medicare Enrollment ID | O20120611000563 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629246137 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 046593 (Georgia) | Primary |
| Provider Name | Eamon K Dutta |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396822979 PECOS PAC ID: 8022060805 Enrollment ID: I20050221000431 |
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