Provider Demographics
NPI:1942485511
Name:DENISE B. PECHT MD PC
Entity Type:Organization
Organization Name:DENISE B. PECHT MD PC
Other - Org Name:PROGRESSIVE HEALTHCARE FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:B
Authorized Official - Last Name:PECHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-339-4000
Mailing Address - Street 1:771 OLD NORCROSS RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-4317
Mailing Address - Country:US
Mailing Address - Phone:770-339-4000
Mailing Address - Fax:770-339-9037
Practice Address - Street 1:771 OLD NORCROSS RD
Practice Address - Street 2:SUITE 305
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-4317
Practice Address - Country:US
Practice Address - Phone:770-339-4000
Practice Address - Fax:770-339-9037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034436207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4482OtherMEDICARE GROUP