NPI 1124000187

Winfred Derrick Moody, MD

Practitioner Dermatology Physician Lawrenceville, GA

Practice location

Address: 565 Old Norcross Rd Suite #200, Lawrenceville, GA 30046-4308
Phone: (770) 962-5040
Fax: (770) 962-5056
Mailing address: 2295 Cape Courage Way, Suwanee, GA 30024-2760

Registered specialties (2)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X Licence 045299 (GA)

Other Dermatology providers in Georgia →

Legal Medicine

Other Service Providers Taxonomy 173000000X Licence 045299 (GA)

Other Legal Medicine providers in Georgia →

Registry record

NPI: 1124000187
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Nov 2005
Record last updated: 16 Feb 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.