Provider Demographics
NPI:1033431820
Name:FINK, DANIEL MARK
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:MARK
Last Name:FINK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6008 HERST RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-1017
Mailing Address - Country:US
Mailing Address - Phone:419-350-2611
Mailing Address - Fax:
Practice Address - Street 1:1290 N MONROE ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3163
Practice Address - Country:US
Practice Address - Phone:734-243-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302030021183500000X
OH03-3-14204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist