NPI 1891540555

Derrick K Staten

Practitioner Non-emergency Medical Transport (VAN) Mableton, GA

Practice location

Address: 518 Mount Gerizim Rd SE, Mableton, GA 30126-6410
Phone: (470) 654-2331

Registered specialties

Non-emergency Medical Transport (VAN) Primary

Transportation Services Taxonomy 343900000X Licence 24064864 (GA)

Other Non-emergency Medical Transport (VAN) providers in Georgia →

Registry record

NPI: 1891540555
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Apr 2024
Record last updated: 17 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.