DR. MARIAM DVALISHVILI M.D.
NPI 1346821675
Student in an Organized Health Care Education/Training Program in Greenville, NC

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since April 19, 2021PECOS Enrolled

2100 STANTONSBURG RD, GREENVILLE, NC 27834(252) 847-4100 Get Directions Write a Review

NPPES record last updated: April 19, 2021. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Mariam Dvalishvili M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. MARIAM DVALISHVILI M.D. (NPI 1346821675) is an individual student in an organized health care education/training program in Greenville, North Carolina and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346821675

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameDR. MARIAM DVALISHVILICredential: M.D.

Location Address2100 STANTONSBURG RDGreenville, NC 27834-2818

Mailing Address2100 Stantonsburg RdGreenville, NC 27834-2818

Phone(252) 847-4100

Sole ProprietorNo

Enumeration DateApril 19, 2021

NPPES CertifiedApril 19, 2021

✔ NPI 1346821675 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

2100 STANTONSBURG RD, Greenville, NC 27834

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mariam Dvalishvili M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.