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Individual

MICHELLE DIANA MON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
354 NEWNAN CROSSING BYP STE 210, NEWNAN, GA 30265-2323
(800) 991-6117
(888) 812-8191
Mailing address
3820 NORTHDALE BLVD STE 201, TAMPA, FL 33624-1893
(800) 991-6117
(888) 812-8191

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
109420
GA
208600000X
Surgery Physician
Primary
109420
GA
208600000X
Surgery Physician
4301109336
MI
208600000X
Surgery Physician
D0085603
MD
208600000X
Surgery Physician
ME93526
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1724199
CIGNA PROVIDER #
FL
05
276170000
FL
01
53238
BCBS PROVIDER #
FL
01
7453614
AETNA PROVIDER #
FL
01
CE7138
MEDICARE GROUP
FL
Enumeration date
03/14/2006
Last updated
11/11/2025
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