Individual
LAVINIA DEBORA DRAMBAREAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3 THOMPSON PARK, HATTIESBURG, MS 39401-8202
(601) 579-3130
(601) 544-3688
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-3130
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00166
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09582002
—
MS
01
—
1141009
CIGNA
MS
01
—
3514185
UNITED HEALTHCARE
MS
01
—
9794999
AETNA
MS
Enumeration date
08/02/2012
Last updated
04/18/2022
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