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General NPI Number Information
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NPI Number | 1518699594
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Entity Type | Individual
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Provider Name | ANKIT DHIMAN
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Gender | Male
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 1475 LANEY WALKER BLVD
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City | AUGUSTA
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State | GA
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Zip | 30912-0002
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Country | US
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Telephone | 706-721-7005
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Fax |
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Provider Business Mailing Address
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Address Line | 636 11TH ST APT 1257
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City | AUGUSTA
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State | GA
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Zip | 30901-2179
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Country | US
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Telephone | 224-504-4117
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 14293
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License Number State | GA
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