MEDICARE: DR. DANIEL D BURWELL 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
1	207Q00000X	Family Medicine Physician	4844	OH

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	:	1720066103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL D BURWELL DO

Provider Business Mailing Address
First Line	:	335 GLESSNER AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44903-2269
Country	:	US
Telephone Number	:	419-520-2495
Fax Number	:

Provider Business Practice Location Address
First Line	:	558 S TRIMBLE RD
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3418
Country	:	US
Telephone Number	:	419-524-1410
Fax Number	:	419-524-2202

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

Provider Enumeration Date	:	01/05/2006
Last Update Date	:	01/25/2022

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