Healthcare Provider Details
I. General information
NPI: 1841290897
Provider Name (Legal Business Name): DANIEL STEVEN HURD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/29/2005
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2617 SHEFFIELD DR NEW RIVER DERMATOLOGY
BLACKSBURG VA
24060-8271
US
IV. Provider business mailing address
2617 SHEFFIELD DR
BLACKSBURG VA
24060-8271
US
V. Phone/Fax
- Phone: 540-953-2210
- Fax: 540-951-9112
- Phone: 540-953-2210
- Fax: 540-951-9112
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | 0102201003 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: