Individual
DR. DANIEL BRADLEY LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3855 PLEASANT HILL ROAD, SUITE 230, DULUTH, GA 30096
(770) 495-8300
(770) 495-7646
Mailing address
721 WELLNESS WAY, SUITE 100, LAWRENCEVILLE, GA 30046
(770) 995-7989
(770) 339-8646
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
038852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000623136A
—
GA
01
—
100012565
RAIL ROAD MEDICARE
GA
01
—
29-06974
UNITED HEALTHCARE
GA
01
—
4575100
MANAGE CARE
GA
01
—
52495718
BLUE CROSS BLUE SHIELD
GA
01
—
582061514003
PRUDENTIAL
GA
01
—
6943
PROMINA
GA
01
—
7462612
CIGNA PPO
GA
Enumeration date
09/02/2005
Last updated
09/25/2012
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