Provider Demographics
NPI:1376632174
Name:TEICHMAN, DAYNA GUTSIN (MD)
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:GUTSIN
Last Name:TEICHMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2797 DOVER RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1207
Mailing Address - Country:US
Mailing Address - Phone:404-352-8998
Mailing Address - Fax:404-352-8990
Practice Address - Street 1:2797 DOVER RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1207
Practice Address - Country:US
Practice Address - Phone:404-352-8998
Practice Address - Fax:404-352-8990
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA044632207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000861341AMedicaid
GAH06304Medicare UPIN
GA000861341AMedicaid