Provider Demographics
NPI:1033969134
Name:DUSON, CHINAZA M
Entity Type:Individual
Prefix:
First Name:CHINAZA
Middle Name:M
Last Name:DUSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 ROXBORO RD NE APT 1201
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1796
Mailing Address - Country:US
Mailing Address - Phone:770-417-7029
Mailing Address - Fax:
Practice Address - Street 1:3450 ROXBORO RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1795
Practice Address - Country:US
Practice Address - Phone:678-881-7411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No347C00000XTransportation ServicesPrivate Vehicle
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No332U00000XSuppliersHome Delivered Meals
No335G00000XSuppliersMedical Foods Supplier
No341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)