Individual
DIANA SOFIA VILLACIS NUNEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1400 TULLIE RD NE, ATLANTA, GA 30329-2309
(404) 785-5437
(404) 785-9096
Mailing address
1400 TULLIE RD NE, ATLANTA, GA 30329-2309
(404) 785-5437
(404) 785-9096
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
82202
GA
2080P0216X
Pediatric Rheumatology Physician
Primary
82202
GA
390200000X
Student in an Organized Health Care Education/Training Program
TRN23252
FL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/04/2016
Last updated
07/19/2022
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