Provider Demographics
NPI:1124137351
Name:LEQUEUX-NALOVIC, KATARINA GABRIELLE (MD)
Entity type:Individual
Prefix:DR
First Name:KATARINA
Middle Name:GABRIELLE
Last Name:LEQUEUX-NALOVIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KATARINA
Other - Middle Name:GABRIELLE
Other - Last Name:CHILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3330 PRESTON RIDGE RD STE 280
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4540
Mailing Address - Country:US
Mailing Address - Phone:404-446-3200
Mailing Address - Fax:404-446-3201
Practice Address - Street 1:3330 PRESTON RIDGE RD STE 280
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4540
Practice Address - Country:US
Practice Address - Phone:404-446-3200
Practice Address - Fax:404-446-3201
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAP50005207ND0101X
GA050005207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00001415OtherRR MEDICARE
07BBSMVMedicare Oscar/Certification
GAH37280Medicare UPIN
H37280Medicare UPIN