Provider Demographics
NPI:1912343617
Name:DANIELS, AMARIS EVANS (MD)
Entity type:Individual
Prefix:MRS
First Name:AMARIS
Middle Name:EVANS
Last Name:DANIELS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:868 YORK AVE SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-2750
Mailing Address - Country:US
Mailing Address - Phone:404-752-1400
Mailing Address - Fax:404-755-7400
Practice Address - Street 1:910 DANNON VW SW STE 2102
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-2156
Practice Address - Country:US
Practice Address - Phone:404-691-6100
Practice Address - Fax:404-755-7400
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA076324208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003151883AMedicaid
GA003147280AMedicaid
GA111982Medicare Oscar/Certification
GA003147280AMedicaid