Healthcare Provider Details

I. General information

NPI: 1033768668
Provider Name (Legal Business Name): DANNEL GEORGE DALEY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2019
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 S EXETER ST
BALTIMORE MD
21202-4316
US

IV. Provider business mailing address

7025 ONYX CT
CAPITOL HEIGHTS MD
20743-1882
US

V. Phone/Fax

Practice location:
  • Phone: 410-962-6520
  • Fax: 410-637-4731
Mailing address:
  • Phone: 301-357-1651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0202218095
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHI00003783
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26787
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: