Individual
DR. JUAN DANIEL MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6600 VAN AALST BLVD, FORT MOORE, GA 31905-2102
(762) 408-2001
(762) 408-2054
Mailing address
6600 VAN AALST BLVD, COLUMBUS, GA 31905-2102
(762) 408-2001
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31009
NE
208D00000X
General Practice Physician
31009
NE
Other
Enumeration date
04/15/2017
Last updated
07/10/2024
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