Individual
DR. DILIANA K PANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
745 SOUTH GLYNN STREET, FAYETTEVILLE, GA 30214
(770) 719-5490
(770) 719-3113
Mailing address
745 SOUTH GLYNN STREET, FAYETTEVILLE, GA 30214
(770) 719-5490
(770) 719-3113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
055270
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510368765A
—
GA
Enumeration date
07/06/2006
Last updated
02/09/2009
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