MEDICARE: CHARLES DANIEL RICE 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	208600000X	Surgery Physician	136299 0	NY

General Provider Information

NPI Number	:	1457332827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES DANIEL RICE MD

Provider Business Mailing Address
First Line	:	5300 MILITARY RD
Second Line	:
City	:	LEWISTON
State	:	NY
Zip	:	14092-2149
Country	:	US
Telephone Number	:	716-298-3012
Fax Number	:	716-298-3016

Provider Business Practice Location Address
First Line	:	5300 MILITARY RD
Second Line	:
City	:	LEWISTON
State	:	NY
Zip	:	14092-2149
Country	:	US
Telephone Number	:	716-298-3012
Fax Number	:	716-298-3016

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	12/21/2009

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