Wannamaker, Daren C
Wannamaker, Daren C is an individual health care provider with primary practice located at 4285 Jim Moore Rd Ste 200 , Dacula GA 30019-1551. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wannamaker, Daren C can be contacted via phone (770) 442-1911.Contact Information
Primary practice address
4285 Jim Moore Rd Ste 200
Dacula GA 30019-1551
Phone: (770) 442-1911
Fax: (770) 442-0306
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 55037 | Georgia |
Profile Details
| NPI number | 1780795708 |
|---|---|
| LBN Legal business name | Wannamaker, Daren C |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2006 |
| Last updated | May 10th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780795708 | NPPES |
| South Carolina | MEDICAID | 003775SC | |
| South Carolina | MEDICAID | 25465600FL |
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