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OIG exclusion detail

FAMILY DERMATOLOGY, P C

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
1144493396
Name
FAMILY DERMATOLOGY, P C
Address
629 BEAVER RUIN ROAD, LILBURN, GA, 30047
Specialty
DERMATOLOGY
Exclusion type
BRCH SA
Exclusion date
20160518
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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