Individual
DR. DAREN C WANNAMAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4285 JIM MOORE RD STE 200, DACULA, GA 30019-1551
(770) 442-1911
(770) 442-0306
Mailing address
805 PEACHTREE ST NE, STE A, ATLANTA, GA 30308-6009
(443) 363-3953
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55037
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003775SC
—
SC
05
—
25465600FL
—
FL
Enumeration date
08/31/2006
Last updated
05/10/2024
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