MEDICARE: DR. DANIEL L GWARTNEY 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	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	2006029317	MO

General Provider Information

NPI Number	:	1942472972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL L GWARTNEY M.D.

Provider Business Mailing Address
First Line	:	3950 N OBERLIN VALLEY RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202-6810
Country	:	US
Telephone Number	:	573-442-2311
Fax Number	:

Provider Business Practice Location Address
First Line	:	3950 N OBERLIN VALLEY RD
Second Line	:
City	:	COLUMBIA
State	:	MO
Zip	:	65202-6810
Country	:	US
Telephone Number	:	573-442-2311
Fax Number	:

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

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	03/31/2008

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