MEDICARE: DR. SAMUEL DANIEL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD2023-1424	NM
2	207RG0100X	Gastroenterology Physician	138448	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083622716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL DANIEL MD

Provider Business Mailing Address
First Line	:	PO BOX 421718
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29442-4203
Country	:	US
Telephone Number	:	843-527-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4040 HIGHWAY 17 UNIT 302
Second Line	:
City	:	MURRELLS INLET
State	:	SC
Zip	:	29576-5098
Country	:	US
Telephone Number	:	843-652-8290
Fax Number	:	843-652-8299

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	05/04/2026

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