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NPI Code Detail

MEDICARE: KENT GALEN MCDANIEL M.D.

MEDICARE: KENT GALEN MCDANIEL M.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
12084P0800XPsychiatry Physician0101052611VA

General Provider Information

NPI Number : 1871640789
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENT GALEN MCDANIEL M.D.
Provider Business Mailing Address
First Line : 201 N MEADOW ST
Second Line :
City : RICHMOND
State : VA
Zip : 23220-3547
Country : US
Telephone Number : 804-355-5361
Fax Number :
Provider Business Practice Location Address
First Line : 10299 WOODMAN RD
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-4419
Country : US
Telephone Number : 804-261-8500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 07/08/2007

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