Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 73005 | GA |
NPI | 1346314069 |
---|---|
Provider Name | Dr. Michael B Dillon |
First Address | Macon, GA 31201-7512 |
Second Address | Macon, GA 31201-7512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 20/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
581087004 | FEI (01) |