Healthcare Provider Details

I. General information

NPI: 1437482783
Provider Name (Legal Business Name): WINSTON DANIELS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2009
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5100 HIGH POINT RD STE.36
UNION CITY GA
30344
US

IV. Provider business mailing address

5100 HIGHPOINT RD APT 36
UNION CITY GA
30291-1138
US

V. Phone/Fax

Practice location:
  • Phone: 678-760-5252
  • Fax:
Mailing address:
  • Phone: 678-760-5252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: