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Individual

TARAS DANYLUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
4700 WATERS AVE, SAVANNAH, GA 31404-6220
(912) 350-3849
Mailing address
6896 W SNOWVILLE RD, BRECKSVILLE, OH 44141-3214

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
46678
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10064481
AMERIGROUP
GA
01
121575904A
PEACHSTATE HEALTH PLAN
GA
05
121575904A
GA
01
884002
BLUE CROSS BLUE SHIELD
GA
05
G46678
SC
01
N194174
WELLCARE
GA
Enumeration date
05/12/2006
Last updated
03/07/2023
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