person
Dmitri Kodor, PA-C
Medical Physician Assistant in Norcross, Georgia
NPI 1679883748

Dmitri Kodor is a Medical Physician Assistant based in Roswell, GA and is specialized in Medical. Dmitri Kodor practices in Norcross, GA and has the professional credentials of PA-C. The NPI Number for Dmitri Kodor is 1679883748 and holds a License No. 02933 (Georgia).

The current practice location address for Dmitri Kodor is 6330 Primrose Hill Ct, Norcross, GA and can be reached out via phone at 770-343-8760 and via fax at 770-664-2101. You can also correspond with Dmitri Kodor through the mailing address at PO BOX 769609, ROSWELL, GA - 30076-8224 (mailing address contact number: 770-343-8760).

Location: 6330 Primrose Hill Ct, Norcross, GA, 30076-8224
person
Provider Profile Details
NPI Number
1679883748
Provider Name
Dmitri Kodor
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
6330 Primrose Hill Ct, Norcross, GA, 30076-8224
Phone Number
770-343-8760
Fax Number
770-664-2101
Provider Enumeration Date
10/07/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003142752A 05 GA
institution
Provider Business Practice Location Address Details
Address
6330 Primrose Hill Ct
City
State
Zip
30092
Phone Number
770-343-8760
Fax Number
770-664-2101
person
Provider Business Mailing Address Details
Address
Po Box 769609
City
State
Zip
30076-8224
Phone Number
770-343-8760
Fax Number
770-664-2101
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
02933 (Georgia)
Definition
Definition to come...
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