Individual
ADDIS DANIEL WINDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
253 GARLAND BRISTOL RD, SAUTEE, GA 30571-2703
(706) 878-2664
(706) 878-2664
Mailing address
253 GARLAND BRISTOL ROAD, SAUTEE, GA 30571-2703
(706) 878-2664
(706) 878-2664
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
013810
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000073169D
—
GA
01
—
300108014
RAILROAD MEDICARE
—
Enumeration date
06/17/2008
Last updated
06/17/2008
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