Provider Demographics
NPI:1902043813
Name:REID, DANA MANSOUR (DO)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:MANSOUR
Last Name:REID
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5755 NORTH POINT PARKWAY
Mailing Address - Street 2:SUITE 67
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022
Mailing Address - Country:US
Mailing Address - Phone:770-212-2249
Mailing Address - Fax:770-212-2253
Practice Address - Street 1:5755 NORTH POINT PARKWAY
Practice Address - Street 2:SUITE 67
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:770-212-2249
Practice Address - Fax:770-212-2253
Is Sole Proprietor?:No
Enumeration Date:2009-01-14
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0657902084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry