Provider Demographics
NPI:1245253236
Name:DYER, DUSKA V (MD)
Entity type:Individual
Prefix:
First Name:DUSKA
Middle Name:V
Last Name:DYER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DUSKA
Other - Middle Name:
Other - Last Name:VRANJESEVIC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4855 RIVER GREEN PKWY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8336
Mailing Address - Country:US
Mailing Address - Phone:770-622-0880
Mailing Address - Fax:770-622-9875
Practice Address - Street 1:4855 RIVER GREEN PKWY
Practice Address - Street 2:SUITE 700
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8336
Practice Address - Country:US
Practice Address - Phone:770-622-0880
Practice Address - Fax:770-622-9875
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA058168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA058168OtherGA MEDICAL LICENSE NUMBER