MEDICARE: DR. KELLY ELIZABETH DANIELS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	0101288808	VA
2	207Y00000X	Otolaryngology Physician	MD489247	PA

General Provider Information

NPI Number	:	1316576788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY ELIZABETH DANIELS MD

Provider Business Mailing Address
First Line	:	3600 FORBES AVE STE 140
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3410
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 GRESHAM DR # 1100
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23507-1904
Country	:	US
Telephone Number	:	757-446-5900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	06/01/2026

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