Provider Demographics
NPI:1336256841
Name:WINSTON, ALAN DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:DANIEL
Last Name:WINSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:770-219-8440
Practice Address - Street 1:200 S ENOTA DR NE
Practice Address - Street 2:SUITE 380
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3473
Practice Address - Country:US
Practice Address - Phone:770-219-7099
Practice Address - Fax:770-219-7923
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA041245208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000968217DMedicaid
GA202I784495OtherMEDICARE PTAN