Basic Information
| Provider Information | |||||||||
| NPI: | 1043730351 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUBINER | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | MICHELLE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | INTERNAL MEDICINE CLINIC | ||||||||
| Address2: | 1801 SUNSET DRIVE | ||||||||
| City: | COLUMBIA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8034344153 | ||||||||
| FaxNumber: | 8034344160 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 CORPORATE CENTER DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | MORROW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302604106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709688888 | ||||||||
| FaxNumber: | 7709602465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2017 | ||||||||
| LastUpdateDate: | 05/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | LL41023 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207W00000X | 88226 | GA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.