Healthcare Provider Details

I. General information

NPI: 1063459220
Provider Name (Legal Business Name): BRYAN D. CHEEVER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 MEMORIAL DR STE G2
DALTON GA
30720-8662
US

IV. Provider business mailing address

800 GI MADDOX PKWY
CHATSWORTH GA
30705-4008
US

V. Phone/Fax

Practice location:
  • Phone: 706-529-3245
  • Fax: 706-626-8063
Mailing address:
  • Phone: 706-529-3245
  • Fax: 706-626-8063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number034120
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number034120
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: