PRANAV DIWAN (NPI# 1306152855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306152855 |
| Entity Type | Individual |
| Full Name | PRANAV DIWAN |
| Credential | M.D. |
| Practice Address |
100 Mimosa Dr Thomasville GA 31792-6676 |
| Mailing Address |
900 Cairo Rd Thomasville GA 31792-4255 |
| Practice Telephone | 2295510083 |
| Enumeration Date | 2010-08-22 |
| Last Update Date | 2015-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
073982 | GA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
073982 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
100 MIMOSA DR |
| City | THOMASVILLE |
| State | GA |
| Zip Code | 31792-6676 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073597753 | Timothy G Grayson | Urology | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2005-12-06 |
| 1902397672 | Fran Maureen Johnson | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2018-05-29 |
| 1619336898 | Archbold Medical Group, Inc. | Urology | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2016-02-17 |
| 1568862068 | Bianca Kierce | Nurse Practitioner | 100 Mimosa Dr, Third Floor, Thomasville, GA 31792-6676 | 2014-09-03 |
| 1871929364 | Leslie C. Stanaland | Nurse Practitioner | 100 Mimosa Dr, 2nd Floor, Thomasville, GA 31792-6676 | 2013-09-17 |
| 1619242781 | Krystyn Riddle | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2012-03-21 |
| 1649543497 | Kelly M Ledger | Nurse Practitioner | 100 Mimosa Dr, 2nd Floor, Thomasville, GA 31792-6676 | 2012-02-09 |
| 1205119005 | Ivey E. Allen | Physician Assistant | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-09-28 |
| 1598057655 | Archbold Medical Group | Surgery | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-05-09 |
| 1760771356 | Mary Kathryn Hanisee | Surgery | 100 Mimosa Dr, Thomasville, GA 31792-6676 | 2011-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245739879 | Georgia Pines Community Service Board | Community/Behavioral Health | 407 Cloverdale Drive, Thomasville, GA 31792 | 2018-02-09 |
| 1932613551 | Diana Diaz | Physician Assistant | 2705 E Pinetree Blvd Ste A, Thomasville, GA 31792 | 2017-11-17 |
| 1194249425 | Bobbie Frazier | Contractor | 400 Cloverdale Dr, Thomasville, GA 31792 | 2017-07-28 |
| 1598132292 | Southern Scripts, LLC | Pharmacy | 501 Gordon Avenue, Thomasville, GA 31792 | 2015-08-28 |
| 1508248915 | Elizabeth Nicole Keen | Behavioral Analyst | 121 Covington Ave Apt 9, Thomasville, GA 31792 | 2015-06-22 |
| 1417341579 | Sheila L Stanley | Counselor | 301 Summercreek Cove, Thomasville, GA 31792 | 2015-03-26 |
| 1457749301 | Ashley Lamb | Speech-Language Pathologist | 1203 East Jackson Street, Thomasville, GA 31792 | 2014-12-30 |
| 1831403880 | Somnoquest | Durable Medical Equipment & Medical Supplies | 556 Hall Road, Thomasville, GA 31792 | 2010-08-02 |
| 1508000183 | Kashyap B Choksi | Internal Medicine | 100 Mimosa Drive 2nd Floor, Thomasville, GA 31792 | 2009-04-27 |
| 1205008786 | Mark J Glaccum | Chiropractor | 415 Gordon Avenue, Thomasville, GA 31792 | 2008-03-25 |
| Find all providers in zip 31792 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669019394 | Champ Vascular, LLC | Internal Medicine | 1825 Highway 34 E Ste 3400, Newnan, GA 30265-6423 | 2019-12-02 |
| 1174006159 | Kendall M Griffith Md LLC | Internal Medicine | 1497 Fair Rd Ste 311, Statesboro, GA 30458-0828 | 2018-09-14 |
| 1558869826 | Coordinated Health of Ga, LLC | Internal Medicine | 10 Glenlake Pkwy Ste 130c, Atlanta, GA 30328-3495 | 2018-01-31 |
| 1447559604 | David Brendan Casey | Internal Medicine | 1700 Tree Ln Ste 100, Snellville, GA 30078-6749 | 2011-03-26 |
| 1730404120 | Deepali Nivas Tukaye | Internal Medicine | 1505 Northside Blvd Ste 3400, Cumming, GA 30041-8223 | 2010-03-29 |
| 1659560647 | Oduwole Organization Inc | Internal Medicine | 1415 Highway 85 N Ste 310-296, Fayetteville, GA 30214-7738 | 2007-10-16 |
| 1053487462 | Tiftarea Cardiology | Internal Medicine | 907 E. 18th St, Ste 100, Tifton, GA 31794 | 2006-11-28 |
| 1255412094 | Jeetendra B Patel | Internal Medicine | 1301 Sigman Rd Ne Ste 200, Conyers, GA 30012 | 2006-10-18 |
| 1811082605 | Cardiac Disease Specialists, PC | Internal Medicine | 296 Merchants Sq, Dallas, GA 30132-5029 | 2006-10-04 |
| 1770508756 | Hunt Dandridge Anderson | Internal Medicine | 4500 Hospital Blvd, Suite 230, Roswell, GA 30076-0003 | 2006-07-12 |
| Find all providers with the same taxonomy | ||||
| City | THOMASVILLE |
| Zip Code | 31792 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.