Dazey, Mary T

Dazey, Mary T is an individual health care provider with primary practice located at 220 Northside Drive , Valdosta GA 31602. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Dazey, Mary T can be contacted via phone (229) 241-2800.

Contact Information

Primary practice address
220 Northside Drive Valdosta GA 31602
Phone: (229) 241-2800
Fax: (229) 241-0454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X R079997 Georgia

Profile Details

NPI number 1871679571
LBN Legal business name Dazey, Mary T
Credentials Certified Nurse Midwife (CNM)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Aug 23rd, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871679571 NPPES
Georgia MEDICAID 00534465D

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