Provider Demographics
NPI:1124655238
Name:WEST, TARYN MARIE DEGRAZIA (MD)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:MARIE DEGRAZIA
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:M
Other - Last Name:DEGRAZIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:100 WOODRUFF CIR NE STE 327
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1020
Mailing Address - Country:US
Mailing Address - Phone:404-727-5658
Mailing Address - Fax:404-727-3744
Practice Address - Street 1:100 WOODRUFF CIR NE STE 327
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1020
Practice Address - Country:US
Practice Address - Phone:404-727-5658
Practice Address - Fax:404-727-3744
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11823207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology