Provider Demographics
NPI:1851463210
Name:LYNN, STEVEN MARC (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MARC
Last Name:LYNN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4015 S COBB DR SE
Mailing Address - Street 2:SUITE 255
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6303
Mailing Address - Country:US
Mailing Address - Phone:770-333-1755
Mailing Address - Fax:770-333-6115
Practice Address - Street 1:4015 S COBB DR SE
Practice Address - Street 2:SUITE 255
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6303
Practice Address - Country:US
Practice Address - Phone:770-333-1755
Practice Address - Fax:770-333-6115
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0274022084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD45975Medicare UPIN
GA26BDCKCMedicare ID - Type Unspecified