1740276328 NPI number — DR. ELVAN CATHERINE DANIELS MD,MPH

Table of content: DR. ELVAN CATHERINE DANIELS MD,MPH (NPI 1740276328)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740276328 NPI number — DR. ELVAN CATHERINE DANIELS MD,MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIELS
Provider First Name:
ELVAN
Provider Middle Name:
CATHERINE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD,MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COBB
Provider Other First Name:
ELVAN
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD,MPH
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1740276328
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 PIEDMONT AVE
Provider Second Line Business Mailing Address:
SUITE 700
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30303-2544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-756-5271
Provider Business Mailing Address Fax Number:
434-756-1402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1513 CLEVELAND AVE BLDG 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30344-6949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-752-1000
Provider Business Practice Location Address Fax Number:
404-752-1229
Provider Enumeration Date:
09/20/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2083P0901X , with the licence number:  050876 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)