Provider Demographics
NPI:1164454153
Name:ALBRITTON, MARK WALDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:WALDEN
Last Name:ALBRITTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3780 OLD NORCROSS RD
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1740
Mailing Address - Country:US
Mailing Address - Phone:404-855-2244
Mailing Address - Fax:404-793-6105
Practice Address - Street 1:3780 OLD NORCROSS RD
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1740
Practice Address - Country:US
Practice Address - Phone:404-855-2244
Practice Address - Fax:404-793-6105
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-03-28
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Provider Licenses
StateLicense IDTaxonomies
GA036082207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCF61263Medicare UPIN