Organization
NEUROLOGY CENTER OF DUBLIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKOLAY BANGIYEV M.D. (OWNER)
(478) 296-7677
Entity
Organization
Contact information
Practice address
206 FAIRVIEW PARK DR, DUBLIN, GA 31021-2547
(478) 296-7677
(478) 296-7704
Mailing address
PO BOX 16550, DUBLIN, GA 31040-6550
(478) 296-7677
(478) 296-7704
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
049998
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140466XX
PREFERRED CARE
GA
01
—
1962409219
NIKOLAY BANGIYEV MD
GA
01
—
326738
WELLCARE
GA
01
—
52864485
BLUE CROSS BLUE SHIELD
GA
Enumeration date
03/27/2007
Last updated
08/22/2020
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