Bangiyev, Nikolay

Bangiyev, Nikolay is an individual health care provider with primary practice located at 206 Fairview Park Dr , Dublin GA 31021-2547. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Bangiyev, Nikolay can be contacted via phone (478) 296-7677.

Contact Information

Primary practice address
206 Fairview Park Dr Dublin GA 31021-2547
Phone: (478) 296-7677
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 049998 Georgia

Profile Details

NPI number 1962409219
LBN Legal business name Bangiyev, Nikolay
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962409219 NPPES
Georgia Other 140466XX PHCS,PREFERRED CARE
Georgia Other 52864485 PHCS,PREFERRED CARE
Georgia MEDICAID 00916253A PHCS,PREFERRED CARE

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