Derosa, Michael A

Derosa, Michael A is an individual health care provider with primary practice located at 2347 Lenora Church Rd , Snellville GA 30078-3232. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Derosa, Michael A can be contacted via phone (770) 979-2020.

Contact Information

Primary practice address
2347 Lenora Church Rd Snellville GA 30078-3232
Phone: (770) 979-2020
Fax: (770) 978-3321
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 033954 Georgia

Profile Details

NPI number 1275524662
LBN Legal business name Derosa, Michael A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Jun 23rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275524662 NPPES
Georgia MEDICAID 00475098A

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