Individual
DR. CHARLES DANIEL PROCTER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
371 E PACES FERRY RD NE STE 750, ATLANTA, GA 30305-2372
(470) 419-4380
(470) 298-7736
Mailing address
2110 POWERS FERRY RD SE STE 302, ATLANTA, GA 30339-5015
(470) 419-4380
(470) 298-7736
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
059108
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52222643
BCBS
GA
01
—
7992557
CIGNA
GA
01
—
9243155
AETNA
GA
Enumeration date
07/13/2006
Last updated
09/19/2022
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