Individual
MICHAEL BRICE DILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(770) 688-3804
(770) 237-6148
Mailing address
P.O. BOX 465117, LAWRENCEVILLE, GA 30042-5117
(770) 688-3804
(770) 237-6148
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
19378
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000232042J
—
GA
05
—
000232042K
—
GA
05
—
00232042D
—
GA
Enumeration date
07/13/2006
Last updated
04/12/2010
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