Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | CHIR009253 | GA |
NPI | 1699142661 |
---|---|
Provider Name | Daniel Day |
First Address | Valdosta, GA 31602-5913 |
Second Address | Valdosta, GA 31602-5913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2015 |
Last Update Date | 09/09/2015 |