Individual
MR. BRIAN A DAITCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5673 PEACHTREE DUNWOODY RD STE 825, ATLANTA, GA 30342
(404) 255-5595
(404) 252-2780
Mailing address
5673 PEACHTREE DUNWOODY RD STE 825, ATLANTA, GA 30342-1771
(404) 255-5595
(404) 252-2780
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3060
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0031111197E
—
GA
Enumeration date
05/12/2006
Last updated
10/21/2019
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