Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RN0300X | Nephrologist | 025600 | GA |
Y | 207RN0300X | Nephrologist | 11596 | SC |
N | 2080P0210X | Pediatric Nephrologist | 025600 | GA |
N | 2080P0210X | Pediatric Nephrologist | 11596 | SC |
NPI | 1578527867 |
---|---|
Provider Name | Dr. Francis J Dibona |
First Address | Aiken, SC 29801-6306 |
Second Address | Aiken, SC 29801-6306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 18/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043723466 | TRICARE PROVIDER NUMBER (01) | SC |
115967 | (05) | SC |
4213010 | AETNA PROVIDER NUMBER (01) | SC |
B91509 | (02) | SC |