Dewoody, Rae Riley

Dewoody, Rae Riley is an individual health care provider with primary practice located at 2801 Dekalb Medical Pkwy , Lithonia GA 30058-4996. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Dewoody, Rae Riley can be contacted via phone (404) 501-8700.

Contact Information

Primary practice address
2801 Dekalb Medical Pkwy Lithonia GA 30058-4996
Phone: (404) 501-8700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 002645 California

Profile Details

NPI number 1942244157
LBN Legal business name Dewoody, Rae Riley
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jan 7th, 2022 - about 4 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 1942244157 NPPES
Georgia MEDICAID 100001061D
Georgia MEDICAID 100001061B
Georgia MEDICAID 100001061C

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