Individual
MARIANA G DIMITROVA HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14870 GRANADA AVE, APPLE VALLEY, MN 55124-5514
(952) 432-3223
Mailing address
14870 GRANADA AVE, APPLE VALLEY, MN 55124-5514
(952) 432-3223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
46344
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46344
MN LICENSE
MN
Enumeration date
06/11/2006
Last updated
07/09/2007
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