Healthcare Provider Details

I. General information

NPI: 1124768296
Provider Name (Legal Business Name): DANIEL LEE WARREN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 10/15/2023
Certification Date: 06/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 UNIVERSITY HOSPITAL DR RM 714
MOBILE AL
36617-2300
US

IV. Provider business mailing address

1601 CENTER STREET, SUITE 3A
MOBILE AL
36604
US

V. Phone/Fax

Practice location:
  • Phone: 251-445-8282
  • Fax:
Mailing address:
  • Phone: 251-665-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberL.5703R
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: