Individual
DR. ALFRED DINGLASAN LUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13570 N MAIN ST, TRENTON, GA 30752-2012
(706) 956-2665
(706) 657-2958
Mailing address
13570 N MAIN ST, TRENTON, GA 30752-2012
(706) 956-2665
(706) 657-2958
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD-16536
HI
207R00000X
Internal Medicine Physician
MDR-5674
HI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
071722
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000211956A
—
GA
Enumeration date
06/25/2009
Last updated
10/19/2017
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