Diversified Diagnostics, Inc

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

DIVERSIFIED DIAGNOSTICS, INC

Practice address

2440 Sandy Plains Rd
Suite 115
Marietta, GA 30066-7217

Phone

(678) 906-1634

NPI assigned

Aug 12, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Maksim Perlin

Title

President

Phone

(678) 906-1634

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407801600000",
    "number": "1790194066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 SANDY PLAINS RD",
            "address_2": "SUITE 115",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300667217",
            "telephone_number": "678-906-1634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 SANDY PLAINS RD",
            "address_2": "SUITE 115",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300667217",
            "telephone_number": "678-906-1634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED DIAGNOSTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-12",
        "last_updated": "2014-08-12",
        "status": "A",
        "authorized_official_last_name": "PERLIN",
        "authorized_official_first_name": "MAKSIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-906-1634",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew G Dishman, LPC
• Olivia Dison
• Joseph Distefano, DPM
• Janet Annikki Dits-Rinta-Koski, RN, MSN, AGNP-C
• Manasi Divan, MSW, RD LD
• Divine Psychology, LLC
• Divine Realign Chiropractic
• Divine Team Behavioral Health Care Inc
• Alexandra Graham Dixon, M.S., LPC, NCC
• Hallea Dixon, RN

• Point of Service in Marietta, GA
• Providers in Marietta, GA by specialty
• Point of Service in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.