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Individual

DHIVYA PRABHAKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6303
Mailing address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6303

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.022821
OH
207R00000X
Internal Medicine Physician
MD-45935
IA
207RH0000X
Hematology (Internal Medicine) Physician
MD-45935
IA
207RH0003X
Hematology & Oncology Physician
MD-45935
IA
207RX0202X
Medical Oncology Physician
Primary
95235
GA
207RX0202X
Medical Oncology Physician
MD-45935
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
95235
GEORGIA MEDICAL LICENSE
GA
Enumeration date
11/05/2013
Last updated
02/27/2024
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