Healthcare Provider Details

I. General information

NPI: 1124282843
Provider Name (Legal Business Name): NAVNEET DHILLON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 08/24/2020
Certification Date: 08/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 RIVERSTONE DR
CANTON GA
30114-5256
US

IV. Provider business mailing address

1835 SAVOY DR SUITE 300
ATLANTA GA
30341-1072
US

V. Phone/Fax

Practice location:
  • Phone: 770-479-1870
  • Fax: 770-479-9705
Mailing address:
  • Phone: 770-479-1870
  • Fax: 770-479-9705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number63651
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA100345
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number063651
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: