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General NPI Number Information
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NPI Number | 1528920329
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Entity Type | Individual
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Provider Name | WILLIAM CHARLES DANIELL CAA
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Gender | Male
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 2415 PARKWOOD DR
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City | BRUNSWICK
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State | GA
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Zip | 31520-4722
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Country | US
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Telephone | 912-466-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 165 PALMERA LN
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City | BRUNSWICK
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State | GA
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Zip | 31525-3065
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Country | US
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Telephone | 912-996-3062
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number | DANI-GPXN3H
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License Number State | GA
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