Provider Demographics
NPI:1487822425
Name:DRAGONU, BEATRIS LUIZA (MD)
Entity Type:Individual
Prefix:
First Name:BEATRIS
Middle Name:LUIZA
Last Name:DRAGONU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8640 ROSWELL RD
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30350-1821
Mailing Address - Country:US
Mailing Address - Phone:770-696-2697
Mailing Address - Fax:770-676-7251
Practice Address - Street 1:8640 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30350-1821
Practice Address - Country:US
Practice Address - Phone:770-696-2697
Practice Address - Fax:770-676-7251
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN52578207Q00000X
GA67209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN080020732Medicare PIN