Healthcare Provider Details

I. General information

NPI: 1205590585
Provider Name (Legal Business Name): AN DAU PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2021
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 OLD ALABAMA RD
JOHNS CREEK GA
30022-5860
US

IV. Provider business mailing address

3000 OLD ALABAMA RD
JOHNS CREEK GA
30022-5860
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-7388
  • Fax:
Mailing address:
  • Phone: 407-437-6896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH033311
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH033311
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: