Provider Demographics
NPI:1982631271
Name:DANCY, MEASHA (MD)
Entity Type:Individual
Prefix:
First Name:MEASHA
Middle Name:
Last Name:DANCY
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 1:11975 MORRIS RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4419
Mailing Address - Country:US
Mailing Address - Phone:678-205-9004
Mailing Address - Fax:
Practice Address - Street 1:11975 MORRIS RD
Practice Address - Street 2:SUITE 140
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4419
Practice Address - Country:US
Practice Address - Phone:678-205-9004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051792207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH73794Medicare UPIN