Provider Demographics
NPI:1811080914
Name:DENNIS-CALDER, DANNA Y (PA)
Entity type:Individual
Prefix:
First Name:DANNA
Middle Name:Y
Last Name:DENNIS-CALDER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DANNA
Other - Middle Name:D
Other - Last Name:CALDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:5555 PEACHTREE DUNWOODY RD STE 190
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1710
Mailing Address - Country:US
Mailing Address - Phone:404-256-4457
Mailing Address - Fax:
Practice Address - Street 1:5555 PEACHTREE DUNWOODY RD STE 190
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1710
Practice Address - Country:US
Practice Address - Phone:404-256-4457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003440363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P09277Medicare UPIN
97BBGRLMedicare ID - Type Unspecified