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NPI Code Detail

MEDICARE: DR. MATTHEW DANIEL COUNCIL MD

MEDICARE: DR. MATTHEW DANIEL COUNCIL MD
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
1207W00000XOphthalmology Physician2008008162MO

General Provider Information

NPI Number : 1942302690
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW DANIEL COUNCIL MD
Provider Business Mailing Address
First Line : 15 THE BOULEVARD SAINT LOUIS
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-1118
Country : US
Telephone Number : 314-863-4200
Fax Number : 314-771-0596
Provider Business Practice Location Address
First Line : 15 THE BOULEVARD SAINT LOUIS
Second Line :
City : RICHMOND HEIGHTS
State : MO
Zip : 63117-1118
Country : US
Telephone Number : 314-863-4200
Fax Number : 314-771-0596
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 10/15/2020

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