MEDICARE: MICHAEL O DANIELS 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
1	207Q00000X	Family Medicine Physician	MD035872E	PA
2	207QG0300X	Geriatric Medicine (Family Medicine) Physician	MD035872E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1012907387	OTHER		NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912907387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL O DANIELS M.D.

Provider Business Mailing Address
First Line	:	303 N BALTIMORE AVE
Second Line	:
City	:	MT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1607
Country	:	US
Telephone Number	:	717-486-8550
Fax Number	:	717-486-3022

Provider Business Practice Location Address
First Line	:	303 N BALTIMORE AVE
Second Line	:
City	:	MT HOLLY SPRINGS
State	:	PA
Zip	:	17065-1607
Country	:	US
Telephone Number	:	717-486-8550
Fax Number	:	717-486-3022

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	11/19/2009

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