Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 22747 | GA |
NPI | 1134270440 |
---|---|
Provider Name | Varada Dinkar Divgi |
First Address | Dunwoody, GA 30338-5684 |
Second Address | Atlanta, GA 30338-6253 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 08/07/2007 |