Search › Georgia › 1835N1003X
Alexandre Ivanov
NPI 1851269823 · on the registry since 2025 · sole proprietor
Practice
- Address
- 2512 Young America Dr
Lawrenceville, GA 30043 - Phone
- (909) 224-4220
Registry record
- Primary taxonomy
- 1835N1003X
1835N1003X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-10-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia