Provider Demographics
NPI:1235301003
Name:DOAN, NGOC DIEM ANKE (MD)
Entity Type:Individual
Prefix:DR
First Name:NGOC
Middle Name:DIEM ANKE
Last Name:DOAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANKE
Other - Middle Name:
Other - Last Name:DOAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5670 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:STE 1200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1699
Mailing Address - Country:US
Mailing Address - Phone:404-255-9100
Mailing Address - Fax:404-257-7171
Practice Address - Street 1:5670 PEACHTREE DUNWOODY RD
Practice Address - Street 2:STE 1200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1699
Practice Address - Country:US
Practice Address - Phone:404-255-9100
Practice Address - Fax:404-257-7171
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64360207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA898030132DMedicaid
GA898030132DMedicaid