Individual
DIMITRIOS K VAVLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 227-3450
Mailing address
PO BOX 3204, INDIANAPOLIS, IN 46206-3204
(706) 227-3450
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
8083
GA
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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