1235163114 NPI number — DR. DANIEL JAMES BELESS M.D.

Table of content: DR. DANIEL JAMES BELESS M.D. (NPI 1235163114)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235163114 NPI number — DR. DANIEL JAMES BELESS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELESS
Provider First Name:
DANIEL
Provider Middle Name:
JAMES
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235163114
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1341 CANTON RD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
MARIETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30066-6056
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-422-0517
Provider Business Mailing Address Fax Number:
678-638-7015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5887 GLENRIDGE DR STE 375
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANDY SPRINGS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30328-6191
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-229-2800
Provider Business Practice Location Address Fax Number:
404-845-9989
Provider Enumeration Date:
07/10/2006

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: 2083P0011X , with the licence number:  023424 , 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)