Provider Demographics
NPI:1669430609
Name:DIZNOFF, EMILY A (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:DIZNOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 WALKER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:BARNARDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28709
Mailing Address - Country:US
Mailing Address - Phone:828-626-3838
Mailing Address - Fax:
Practice Address - Street 1:41 OAKLAND RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4820
Practice Address - Country:US
Practice Address - Phone:828-252-8885
Practice Address - Fax:828-252-9420
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200201070207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I07315Medicare UPIN
NC2025935Medicare PIN