MEDICARE: DR. MICHAEL DANIELS, LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1467857623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MICHAEL DANIELS, LLC

Provider Business Mailing Address
First Line	:	303 N BALTIMORE AVE
Second Line	:
City	:	MOUNT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1607
Country	:	US
Telephone Number	:	717-486-8550
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 N BALTIMORE AVE
Second Line	:
City	:	MOUNT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1607
Country	:	US
Telephone Number	:	717-486-8550
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL OWAIN DANIELS
Credential	:	MD
Telephone Number	:	717-486-8550

Provider Enumeration Date	:	10/30/2014
Last Update Date	:	10/30/2014

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