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Southern Dermatology PC

NPI 1437437837ActiveOrganization· Dermatology· Lawrenceville, GA

Dermatology in Lawrenceville, Georgia, registered in NPPES in August 2011. The authorized official on file is Winfred Derrick Moody, M.D., Owner. Enrolled in Medicare as part b supplier - clinic/group practice.

Overview

NPI1437437837
StatusActive
Entity typeOrganization
NPI issuedAug 2, 2011
Last updated in NPPESSep 28, 2011

Specialties and licenses

TaxonomyCodeLicenseState
Dermatology Primary207N00000X045299GA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Part B Supplier - Clinic/Group Practice (GA)

Medicare sources and data years

Other Dermatology providers in Lawrenceville

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