Provider Demographics
NPI:1023878147
Name:DHALIWAL, OLIVIA MANGAT (MD)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:MANGAT
Last Name:DHALIWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 NC-105 EXTENSION
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:26807
Mailing Address - Country:US
Mailing Address - Phone:828-262-4100
Mailing Address - Fax:
Practice Address - Street 1:APP FAMILY MEDICINE
Practice Address - Street 2:148 NC-105 EXTENSION, SUITE 102
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:26807
Practice Address - Country:US
Practice Address - Phone:828-262-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-19
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program