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General NPI Number Information
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NPI Number | 1629777354
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Entity Type | Individual
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Provider Name | DIALA A MINKARA APRN
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Gender | Female
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Dates
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Enumeration Date | 03/02/2023
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Last Update Date | 03/02/2023
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Provider Practice Location Address
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Address Line | 93 ROBIN RD
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City | RINGGOLD
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State | GA
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Zip | 30736-2415
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Country | US
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Telephone | 706-861-4508
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Fax |
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Provider Business Mailing Address
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Address Line | 6845 MOUNTAIN VIEW RD
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City | OOLTEWAH
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State | TN
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Zip | 37363-6561
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Country | US
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Telephone | 423-910-0896
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 33536
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License Number State | TN
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