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Individual

WESLEY LEWIS DANIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
1975 BEVERLY RD, SUITE B, GAINESVILLE, GA 30501-2034
(770) 536-9908
(770) 532-7102
Mailing address
1975 BEVERLY RD, SUITE B, GAINESVILLE, GA 30501-2034
(770) 536-9908
(770) 532-7102

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
395
GA
213ES0131X
Foot Surgery Podiatrist
395
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00064435A
GA
Enumeration date
11/13/2006
Last updated
08/25/2008
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