Provider Demographics
NPI:1851486955
Name:DEJOSEPH, LOUIS MICHAEL (MD,)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:MICHAEL
Last Name:DEJOSEPH
Suffix:
Gender:M
Credentials:MD,
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Mailing Address - Street 1:6085 BARFIELD ROAD NORTHEAST SUITE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:770-457-6303
Mailing Address - Fax:770-457-2823
Practice Address - Street 1:6085 BARFIELD ROAD NORTHEAST SUITE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-457-6303
Practice Address - Fax:770-457-2823
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0525542082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH95375Medicare UPIN