Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miss. Deidra Dyan Munsanto, PA-C

Individual provider Physician Assistant · NPI 1235432170

Miss. Deidra Dyan Munsanto, PA-C is a Physician Assistant in Woodstock, Georgia. Qualified in 2010, 16 years ago. Practices with Wellstar Medical Group LLC, a 3,072-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Georgia and Oklahoma.

Years since qualifying
16
Licensed in
GA, OK
In the registry since
2010
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

12201 Highway 92 Ste D
Woodstock, GA 30188
Phone: (770) 517-4621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1601 Sw 89th St Ste E200, Oklahoma City, OK 73159-6380 — (405) 702-4435
  • 1601 Sw 89th St Ste E200, Oklahoma City, OK 73159-6380 — (405) 702-4435

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X (GA)
Physician Assistant Taxonomy 363A00000X · Licence 1937 (OK)

Record details

NPI number1235432170
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 15, 2010
Last updated in NPPESNovember 6, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Wellstar Medical Group Llc — 3072 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Woodstock