MEDICARE: WILLIAM DANA FLANDERS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2083P0901X	Public Health & General Preventive Medicine Physician	034588	GA

General Provider Information

NPI Number	:	1962899948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM DANA FLANDERS MD

Provider Business Mailing Address
First Line	:	2419 HIGHLAND GRV NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3895
Country	:	US
Telephone Number	:	404-633-7766
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 HIGHLAND GRV NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30345-3895
Country	:	US
Telephone Number	:	404-633-7766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2015
Last Update Date	:	04/17/2015

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