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Individual

DIMKA M IALAMOVA-TOUNTCHEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39331
TN
208M00000X
Hospitalist Physician
39331
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3325769
TN
01
4122136
BCBST
TN
01
P00334011
RR MEDICARE
TN
01
TN0101
JOHN DEERE HEALTHCARE
TN
Enumeration date
12/28/2005
Last updated
05/08/2014
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