Healthcare Provider Details

I. General information

NPI: 1730516469
Provider Name (Legal Business Name): CARA DANIELS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2013
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 PEACHTREE DUNWOODY RD SJH CRITICAL CARE
ATLANTA GA
30342-1764
US

IV. Provider business mailing address

5665 PEACHTREE DUNWOODY RD SJH CRITICAL CARE
ATLANTA GA
30342-1764
US

V. Phone/Fax

Practice location:
  • Phone: 678-420-4175
  • Fax: 678-420-4111
Mailing address:
  • Phone: 678-420-4175
  • Fax: 678-420-4111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7031
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: