Provider Demographics
NPI:1043203599
Name:ROJAS-MOLINA, DANIELA MARIA (MD)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:MARIA
Last Name:ROJAS-MOLINA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELA
Other - Middle Name:MARIA
Other - Last Name:ROJAS MOLINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:165 BLUE RIDGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4431
Mailing Address - Country:US
Mailing Address - Phone:706-946-5607
Mailing Address - Fax:706-374-7628
Practice Address - Street 1:772 MADDOX DR STE 122
Practice Address - Street 2:
Practice Address - City:EAST ELLIJAY
Practice Address - State:GA
Practice Address - Zip Code:30540-8196
Practice Address - Country:US
Practice Address - Phone:706-635-6898
Practice Address - Fax:706-356-6885
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055331207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA113534570DMedicaid
GA20208I6372OtherMEDICARE PTAN
GA113534570DMedicaid
GA113534570DMedicaid