Provider Demographics
NPI:1154377554
Name:DONCHEV, YULIYAN (MD)
Entity type:Individual
Prefix:
First Name:YULIYAN
Middle Name:
Last Name:DONCHEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 SANDY PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3020
Mailing Address - Country:US
Mailing Address - Phone:770-977-4547
Mailing Address - Fax:770-977-8354
Practice Address - Street 1:3600 SANDY PLAINS RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3020
Practice Address - Country:US
Practice Address - Phone:770-977-4547
Practice Address - Fax:770-977-8354
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01061776A207Q00000X
GA062680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000478486OtherANTHEM
IN214180EMedicare PIN
INI56095Medicare UPIN