Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 0102204647 | VA |
N | 2081P2900X | Pain Medicine | 0102204647 | VA |
NPI | 1114309267 |
---|---|
Provider Name | Dr. Yi Ding |
First Address | Marietta, GA 30060-7902 |
Second Address | Marietta, GA 30060-7902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2015 |
Last Update Date | 21/07/2021 |