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Individual

MR. DANIEL WILSON KREVDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA

Contact information

Practice address
901 GRIFFIN AVE, EASTMAN, GA 31023-6720
(478) 448-4048
(478) 374-9797
Mailing address
621 NORTH AVENUE, NE, SUITE C-30, ATLANTA, GA 30308
(678) 904-6820
(678) 904-6824

Taxonomy

Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
JX39313
FL
2471C3402X
Radiography Radiologic Technologist
JX39313
FL
2471V0106X
Vascular-Interventional Technology Radiologic Technologist
JX39313
FL
363AM0700X
Medical Physician Assistant
Primary

Other

Enumeration date
06/29/2007
Last updated
09/11/2025
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