Healthcare Provider Details

I. General information

NPI: 1871889188
Provider Name (Legal Business Name): DANIEL KENNETH CASE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 GOOD LUCK RD
LANHAM MD
20706-3574
US

IV. Provider business mailing address

425 Q ST NW
WASHINGTON DC
20001-2443
US

V. Phone/Fax

Practice location:
  • Phone: 301-552-8665
  • Fax:
Mailing address:
  • Phone: 860-508-0462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMT200041
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD045983
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0077506
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: