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Organization

ATHENS DIABETES AND ENDOCRINOLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PETER FRANDSEN VANDYCK MD (OWNER)
(706) 549-4155
Entity
Organization

Contact information

Practice address
3320 OLD JEFFERSON RD STE 600, ATHENS, GA 30607-1463
(706) 549-4155
(706) 546-0036
Mailing address
3320 OLD JEFFERSON RD STE 600, ATHENS, GA 30607-1463
(706) 549-4155
(706) 546-0036

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
27679
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0384997B
GA
Enumeration date
05/25/2007
Last updated
12/15/2009
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