Individual
PETER FRANDSEN VANDYCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3320 OLD JEFFERSON RD, BUILDING 600, ATHENS, GA 30607-1400
(706) 549-4155
(706) 546-0036
Mailing address
3320 OLD JEFFERSON RD STE 300A, ATHENS, GA 30607-1442
(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
—
00384997B
—
GA
01
—
52022022
BLUE CROSS
GA
Enumeration date
12/26/2006
Last updated
01/07/2019
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