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Individual

DONALD E. MAUNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
299 N BROAD ST, WINDER, GA 30680-2155
(770) 867-2120
Mailing address
299 N BROAD ST, WINDER, GA 30680-2155
(770) 867-2120

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
001408
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001408
STATE LICENSE
GA
05
822855513A
GA
Enumeration date
04/26/2007
Last updated
10/06/2011
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