Healthcare Provider Details
I. General information
NPI: 1750389730
Provider Name (Legal Business Name): DANIEL N COAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/13/2005
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1198 S GOVERNORS AVE STE B100
DOVER DE
19904-6930
US
IV. Provider business mailing address
4923 OGLETOWN STANTON RD SUITE 200
NEWARK DE
19713-2081
US
V. Phone/Fax
- Phone: 302-734-3227
- Fax: 302-734-0391
- Phone: 302-225-0451
- Fax: 302-225-0472
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | C10003652 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: