Healthcare Provider Details

I. General information

NPI: 1992351407
Provider Name (Legal Business Name): DANIEL O'MEARA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2019
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 N DRUID HILLS RD NE
ATLANTA GA
30329-3117
US

IV. Provider business mailing address

2220 N DRUID HILLS RD NE
ATLANTA GA
30329-3117
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-2593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number95237
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: