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General NPI Number Information
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NPI Number | 1750067716
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Entity Type | Individual
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Provider Name | DANIELLE CALLAWAY GODFREY MD
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/26/2023
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Provider Practice Location Address
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Address Line | 1446 HARPER ST
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City | AUGUSTA
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State | GA
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Zip | 30912
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Country | US
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Telephone | 540-553-1059
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 RIDGECREST DR
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City | AUGUSTA
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State | GA
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Zip | 30907
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Country | US
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Telephone | 540-553-1059
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 15162
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License Number State | GA
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