Healthcare Provider Details

I. General information

NPI: 1518181148
Provider Name (Legal Business Name): DANIEL FREDERICK BOXWELL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 STORK WAY
SENECA SC
29678-1039
US

IV. Provider business mailing address

215 STORK WAY
SENECA SC
29678-1039
US

V. Phone/Fax

Practice location:
  • Phone: 248-310-3473
  • Fax:
Mailing address:
  • Phone: 248-310-3473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number1521
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: