Provider Demographics
NPI:1043204498
Name:PECHT, DENISE B (MD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:B
Last Name:PECHT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:575 PROFESSIONAL DR
Mailing Address - Street 2:STE 580
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-3333
Mailing Address - Country:US
Mailing Address - Phone:770-339-4000
Mailing Address - Fax:770-339-9037
Practice Address - Street 1:575 PROFESSIONAL DR
Practice Address - Street 2:STE 580
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-3333
Practice Address - Country:US
Practice Address - Phone:770-339-4000
Practice Address - Fax:770-339-9037
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2007-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA034436207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE58276Medicare UPIN
GA16BBBSGMedicare PIN