Individual
DR. ASHANDA ESDAILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1120 15TH STREET, AUGUSTA, GA 30912-0004
(706) 721-8623
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
73461-20
WI
208800000X
Urology Physician
73461-20
WI
208800000X
Urology Physician
Primary
92365
GA
208800000X
Urology Physician
D0100558
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/05/2015
Last updated
07/18/2024
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