Provider Demographics
NPI:1750044483
Name:RADUCAN, DANIELA (RPH)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:
Last Name:RADUCAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2781 LAVISTA RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-1713
Mailing Address - Country:US
Mailing Address - Phone:404-929-1013
Mailing Address - Fax:
Practice Address - Street 1:2781 LAVISTA RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-1713
Practice Address - Country:US
Practice Address - Phone:404-929-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032542183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist