Individual
DR. DANIEL SCOTT VANDERENDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. DTM&H
Contact information
Practice address
408 OAKLAND ST, DECATUR, GA 30030-2431
(404) 686-7869
Mailing address
408 OAKLAND ST, DECATUR, GA 30030-2431
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101239536
VA
207R00000X
Internal Medicine Physician
Primary
58026
GA
207R00000X
Internal Medicine Physician
MD0000032003
TN
207R00000X
Internal Medicine Physician
TL28808
SC
Other
Enumeration date
06/10/2006
Last updated
06/22/2012
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