Provider Demographics
NPI:1750301487
Name:KRALIS, DANIEL FRANK (MMSCI, AA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:FRANK
Last Name:KRALIS
Suffix:
Gender:M
Credentials:MMSCI, AA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 STONE MOUNTAIN HWY
Mailing Address - Street 2:PMB 344, SUITE D
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6416
Mailing Address - Country:US
Mailing Address - Phone:404-686-2316
Mailing Address - Fax:
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-2316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002096367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant