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General NPI Number Information
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NPI Number | 1861928749
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Entity Type | Organization
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Legal Business Name | STEPHANIE DANIEL MD PLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 901 W REX ALLEN DR
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City | WILLCOX
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State | AZ
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Zip | 85643-1009
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Provider Business Mailing Address
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Address Line | 16772 W BELL RD STE 110-127
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City | SURPRISE
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State | AZ
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Zip | 85374-9702
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Country | US
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Telephone | 702-453-3799
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Fax | 702-453-5741
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Authorized Official
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Title or Position | SOLE OWNER
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Name | STEPHANIE DANIEL
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Credential | MD
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Telephone | 602-341-0904
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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 | 52709
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License Number State | AZ
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