Individual
PRANAV DIWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MIMOSA DR, THOMASVILLE, GA 31792-6676
(229) 551-0083
Mailing address
900 CAIRO RD, THOMASVILLE, GA 31792-4255
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
073982
GA
207RI0011X
Interventional Cardiology Physician
Primary
073982
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/22/2010
Last updated
05/18/2015
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