GVANTSA DIDEBULIDZE

BROCKTON, MA
NPI1730474644
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: MA  257775)
Enumeration Date2011-06-20
Last Update Date2014-10-14
Business Address
-- GVANTSA DIDEBULIDZE M.D
63 MAIN ST
BROCKTON, MA 02301-4042
Phone number: 508-559-6699
Mailing Address
-- GVANTSA DIDEBULIDZE M.D
63 MAIN ST
BROCKTON, MA 02301-4042
Phone number: 508-559-6699
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