Provider Demographics
NPI:1447277256
Name:LOW, DIONG O (MD)
Entity type:Individual
Prefix:DR
First Name:DIONG
Middle Name:O
Last Name:LOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:490 MIKASA DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-7934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5245 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2621
Practice Address - Country:US
Practice Address - Phone:770-448-3953
Practice Address - Fax:770-447-9521
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032943207Q00000X
GA32943208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00570611BMedicaid
GA00570611CMedicaid
GA00570611BMedicaid