Provider Demographics
NPI:1518927854
Name:DANEKER, GEORGE W (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:W
Last Name:DANEKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5115 NEW PEACHTREE RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-3326
Mailing Address - Country:US
Mailing Address - Phone:678-336-5951
Mailing Address - Fax:678-336-5955
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1731
Practice Address - Country:US
Practice Address - Phone:404-252-6118
Practice Address - Fax:404-252-8016
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035844208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
C46402Medicare UPIN
02BDJBDMedicare ID - Type Unspecified