MEDICARE: KARREN REESE DANIELS O.D.

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	152W00000X	Optometrist	TA1045	MD

General Provider Information

NPI Number	:	1497876999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARREN REESE DANIELS O.D.

Provider Business Mailing Address
First Line	:	15200 JENNINGS LN
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20721-7209
Country	:	US
Telephone Number	:	301-390-7032
Fax Number	:

Provider Business Practice Location Address
First Line	:	48 WATKINS PARK DR
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20774-1628
Country	:	US
Telephone Number	:	301-249-5890
Fax Number	:

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

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	07/08/2007

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