Healthcare Provider Details

I. General information

NPI: 1902366693
Provider Name (Legal Business Name): MICHAEL JOSEPH DANAHER III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2019
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1065 WILLIAMSBURG WAY APT 6410
EVANS GA
30809-7659
US

V. Phone/Fax

Practice location:
  • Phone: 762-375-2741
  • Fax:
Mailing address:
  • Phone: 607-765-9541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number104780
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: