Individual
DANE A ULETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2045 PEACHTREE RD NE STE 810, ATLANTA, GA 30309-1412
(404) 446-1890
(404) 446-1898
Mailing address
900 CIRCLE 75 PKWY SE STE 900, ATLANTA, GA 30339-3084
(678) 426-2171
(404) 446-1957
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000960
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000947196K
—
GA
05
—
000947196L
—
GA
01
—
2847290
AETNA
GA
01
—
323277
UNITED HEALTHCARE
GA
05
—
336928
—
GA
01
—
52887103-033
BLUE CROSS BLUE SH OF GA
GA
01
—
581994261
CIGNA
GA
01
—
P00465728
RAILROAD MEDICARE
GA
Enumeration date
04/06/2006
Last updated
12/03/2019
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