Provider Demographics
NPI:1053405993
Name:ESTEVES, DANIEL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:ESTEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2169 LAWRENCEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7710
Mailing Address - Country:US
Mailing Address - Phone:770-676-5878
Mailing Address - Fax:678-585-1136
Practice Address - Street 1:2169 LAWRENCEVILLE HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7710
Practice Address - Country:US
Practice Address - Phone:770-676-5878
Practice Address - Fax:678-585-1136
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6230207V00000X
GA61881207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA640386678AMedicaid
TX8C6832Medicare PIN
TXH91773Medicare UPIN
GA202I164353Medicare PIN