Healthcare Provider Details

I. General information

NPI: 1295094431
Provider Name (Legal Business Name): ELDRA W DANIELS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2012
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LEFEVER RD
MOUNT JOY PA
17552-8803
US

IV. Provider business mailing address

PO BOX 858 MCA410
HERSHEY PA
17033-0858
US

V. Phone/Fax

Practice location:
  • Phone: 717-653-2910
  • Fax: 717-653-2910
Mailing address:
  • Phone: 800-243-1455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberMD467809
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: