Individual
MRS. ILIANA DIAZ HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
3450 ACWORTH DUE WEST RD NW, BLDG 200 STE 220, KENNESAW, GA 30144-1001
(770) 794-6643
(770) 794-6683
Mailing address
3450 ACWORTH DUE WEST RD NW, BLDG 200 STE 220, KENNESAW, GA 30144-1001
(770) 794-6643
(770) 794-6683
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
06/10/2010
Last updated
06/02/2021
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