Individual
MARIN DIMITROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3810
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD27711
TN
208M00000X
Hospitalist Physician
27711
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010185351
—
VA
05
—
3098470
—
TN
05
—
3098479
—
TN
05
—
3810011575
—
WV
Enumeration date
06/01/2006
Last updated
09/24/2008
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