Healthcare Provider Details

I. General information

NPI: 1053405993
Provider Name (Legal Business Name): DANIEL ESTEVES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2169 LAWRENCEVILLE HWY
LAWRENCEVILLE GA
30044-7710
US

IV. Provider business mailing address

2169 LAWRENCEVILLE HWY
LAWRENCEVILLE GA
30044-7710
US

V. Phone/Fax

Practice location:
  • Phone: 770-676-5878
  • Fax: 678-585-1136
Mailing address:
  • Phone: 770-676-5878
  • Fax: 678-585-1136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberL6230
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number61881
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: