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General NPI Number Information
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NPI Number | 1225247448
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Entity Type | Organization
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Legal Business Name | T. DANIEL CADDELL MD
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 907 NORTH MAIN STREET
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City | TRAVELERS REST
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State | SC
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Zip | 29690
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Country | US
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Telephone | 864-834-4191
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Fax | 864-834-1964
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Provider Business Mailing Address
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Address Line | PO BOX 1054
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City | TRAVELERS REST
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State | SC
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Zip | 29690-1054
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Country | US
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Telephone | 864-834-4191
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Fax | 864-834-1964
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. TITUS DANIEL CADDELL
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Credential | MD,PA
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Telephone | 864-834-4191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12475
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License Number State | SC
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