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General NPI Number Information
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NPI Number | 1639148703
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Entity Type | Individual
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Provider Name | MICHELLE DIANA MON MD
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Gender | Female
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 354 NEWNAN CROSSING BYP STE 210
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City | NEWNAN
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State | GA
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Zip | 30265-2323
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Country | US
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Telephone | 800-991-6117
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Fax | 888-812-8191
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Provider Business Mailing Address
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Address Line | 3820 NORTHDALE BLVD STE 201
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City | TAMPA
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State | FL
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Zip | 33624-1893
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Country | US
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Telephone | 800-991-6117
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Fax | 888-812-8191
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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 | 109420
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 109420
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME93526
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301109336
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0085603
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License Number State | MD
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