Provider Demographics
NPI:1619408051
Name:ORTEGA, DANIELLE HUNT (DO)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:HUNT
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3890 REDWINE RD SW STE 100
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5583
Mailing Address - Country:US
Mailing Address - Phone:404-344-0059
Mailing Address - Fax:404-344-9195
Practice Address - Street 1:3890 REDWINE RD SW STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-5583
Practice Address - Country:US
Practice Address - Phone:404-344-0059
Practice Address - Fax:404-344-9195
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151013349207Q00000X
GA95545207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine