Provider Demographics
NPI:1962273276
Name:VARGA, DANIEL JR (CP-C, NREMT-P, HC)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:VARGA
Suffix:JR
Gender:M
Credentials:CP-C, NREMT-P, HC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WALDEN CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31216-7663
Mailing Address - Country:US
Mailing Address - Phone:478-751-8732
Mailing Address - Fax:
Practice Address - Street 1:105 WALDEN CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31216-7663
Practice Address - Country:US
Practice Address - Phone:478-751-8732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X, 175F00000X
GAINS-0479174H00000X
GAP030988146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
No171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No175F00000XOther Service ProvidersNaturopath