Individual
DR. LILLIAN KIM IVANSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., M.P.H.
Contact information
Practice address
20 GLENLAKE PKWY, ATLANTA, GA 30328-3473
(404) 364-7285
Mailing address
3495 PIEDMONT RD NE, ATLANTA, GA 30305-1717
(404) 364-7285
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-37114
KS
2085R0202X
Diagnostic Radiology Physician
Primary
069869
GA
2085R0202X
Diagnostic Radiology Physician
27713
NE
2085R0202X
Diagnostic Radiology Physician
53370
CO
2085R0202X
Diagnostic Radiology Physician
MD17668
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025709000
—
NE
05
—
10026277300
—
NE
05
—
10026277400
—
NE
05
—
10026277500
—
NE
05
—
10026277600
—
NE
05
—
10026277700
—
NE
05
—
10026277800
—
NE
05
—
1043478605
—
IA
05
—
1043478605
—
MT
05
—
1043478605
—
UT
05
—
1043478605
—
WY
05
—
201098570A
—
KS
05
—
66229006
—
NM
05
—
79754571
—
CO
05
—
929695
—
AZ
Enumeration date
05/29/2008
Last updated
01/10/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us