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Contact Information

DEIDRA D MUNSANTO, PA-C
12201 HIGHWAY 92 STE D
WOODSTOCK, GA30188
 Phone: 770-517-4621
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for DEIDRA D MUNSANTO · (Female)

NPI # 1235432170
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 12/15/2010
Last updated 11/06/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 1937
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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