MEDICARE: BEATRIS LUIZA DRAGONU MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	52578	MN
2	207Q00000X	Family Medicine Physician	67209	GA

General Provider Information

NPI Number	:	1487822425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEATRIS LUIZA DRAGONU MD

Provider Business Mailing Address
First Line	:	8640 ROSWELL RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-1821
Country	:	US
Telephone Number	:	770-696-2697
Fax Number	:	770-676-7251

Provider Business Practice Location Address
First Line	:	8640 ROSWELL RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30350-1821
Country	:	US
Telephone Number	:	770-696-2697
Fax Number	:	770-676-7251

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2008
Last Update Date	:	08/21/2015

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