Provider Demographics
NPI:1568469799
Name:CERENKO, DANKO (PHD, MD)
Entity Type:Individual
Prefix:DR
First Name:DANKO
Middle Name:
Last Name:CERENKO
Suffix:
Gender:M
Credentials:PHD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 HIGHWAY 54 W BLDG 700 STE 710
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4565
Mailing Address - Country:US
Mailing Address - Phone:770-991-2800
Mailing Address - Fax:770-997-3827
Practice Address - Street 1:1240 HIGHWAY 54 W BLDG 700 STE 710
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4565
Practice Address - Country:US
Practice Address - Phone:770-991-2800
Practice Address - Fax:770-997-3827
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033244207YS0012X, 207YX0901X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000578597CMedicaid
GA000578597EMedicaid
GA2747255OtherAETNA
GA5896670OtherCIGNA
GA000578597DMedicaid
GA40016984OtherRAILROAD MEDICARE
GA52048662OtherBCBS OF GEORGIA
GA000578597DMedicaid
GA000578597CMedicaid