Individual
DR. ELIAS DAGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9635 VENTANA WAY STE 201, JOHNS CREEK, GA 30022-8622
(404) 446-4424
(404) 446-4420
Mailing address
11877 DOUGLAS RD, SUITE 102-272, ALPHARETTA, GA 30005-4325
(404) 446-4424
(404) 446-4420
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
054606
GA
207T00000X
Neurological Surgery Physician
ME96941
FL
207T00000X
Neurological Surgery Physician
Primary
ME96941
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277245100
—
FL
05
—
838984626A
—
GA
Enumeration date
06/24/2005
Last updated
12/19/2019
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