Healthcare Provider Details

I. General information

NPI: 1316500994
Provider Name (Legal Business Name): DANIEL ELMES DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 N TAYLOR DR
SHEBOYGAN WI
53081-1989
US

IV. Provider business mailing address

1441 N TAYLOR DR
SHEBOYGAN WI
53081-1989
US

V. Phone/Fax

Practice location:
  • Phone: 920-298-2821
  • Fax: 920-287-7500
Mailing address:
  • Phone: 920-298-2821
  • Fax: 920-287-7500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number1202-25
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: