MEDICARE: MRS. DANIELLE ELISA PRICE PA-C

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	363AM0700X	Medical Physician Assistant	C05847	MD

General Provider Information

NPI Number	:	1750766796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE ELISA PRICE PA-C

Provider Business Mailing Address
First Line	:	12414 NAVES CROSS RD NE
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-8212
Country	:	US
Telephone Number	:	240-808-8482
Fax Number	:

Provider Business Practice Location Address
First Line	:	12414 NAVES CROSS RD NE
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-8212
Country	:	US
Telephone Number	:	240-808-8482
Fax Number	:

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

Provider Enumeration Date	:	07/20/2015
Last Update Date	:	06/18/2026

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