Individual
ANDREA BLAIRE DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
1520 WILLOW PARK WAY, CUMMING, GA 30041-7902
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
185408
GA
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
10/20/2018
Last updated
11/23/2021
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