Itoro Bassey Edet Daniels, MD
Internal Medicine in Greensboro, GA. Individual provider (NPI-1).
NPI number1508202995
StatusActive
Last updated in NPPESSep 8, 2022
Details
- NPI
- 1508202995
- Entity type
- Individual (NPI-1)
- Name
- Itoro Bassey Edet Daniels
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 13, 2013
- Certification date
- Sep 8, 2022
- Last updated
- Sep 8, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 080742 | GA | Yes |
| 207R00000X | Internal Medicine | R73852 | AZ | |
| 208000000X | Pediatrics | R73852 | AZ |
Practice location
803 S Main StGreensboro, GA 30642
Phone 706-454-5114 · Fax 706-454-5199
Mailing address
803 S Main StGreensboro, GA 30642-1211
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