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NPI Code Detail

MEDICARE: DANIEL J MAYDONOVITCH DO

MEDICARE: DANIEL J MAYDONOVITCH DO
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
1207Q00000XFamily Medicine PhysicianOS007688LPA

General Provider Information

NPI Number : 1154396802
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL J MAYDONOVITCH DO
Provider Business Mailing Address
First Line : 23 N WALNUT ST
Second Line :
City : BOYERTOWN
State : PA
Zip : 19512-1467
Country : US
Telephone Number : 610-367-2259
Fax Number : 610-367-0505
Provider Business Practice Location Address
First Line : 23 N WALNUT ST
Second Line :
City : BOYERTOWN
State : PA
Zip : 19512-1467
Country : US
Telephone Number : 610-367-2259
Fax Number : 610-367-0505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/17/2006
Last Update Date : 01/20/2019

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Directions to “ DANIEL J MAYDONOVITCH DO” Practice Location

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