MEDICARE: DANIELSON SURGICAL ASSOCIATES

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	261QA1903X	Ambulatory Surgical Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	I3397	OTHER	VT	RAIL ROAD MEDICARE

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	:	1760431878
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIELSON SURGICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	1290 HOSPITAL DR
Second Line	:
City	:	ST JOHNSBURY
State	:	VT
Zip	:	05819-9205
Country	:	US
Telephone Number	:	802-748-2984
Fax Number	:

Provider Business Practice Location Address
First Line	:	1290 HOSPITAL DR
Second Line	:
City	:	ST JOHNSBURY
State	:	VT
Zip	:	05819-9205
Country	:	US
Telephone Number	:	802-748-2984
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KENNETH S DANIELSON
Credential	:	M.D.
Telephone Number	:	802-748-2984

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	04/06/2012

Similar Medicare Providers

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1962654335 — DAVID S BRODY, MD
Practice Location Address:

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1942597489 — DR. MARK CHRISTOPHER PLUYM M.D.
Practice Location Address:

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1588018527 — SARA AZHAR ZAIDI DPM
Practice Location Address:

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Directions to “DANIELSON SURGICAL ASSOCIATES ” Practice Location

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