Provider Demographics
NPI:1124386073
Name:BURDICK, DANIEL SHAWN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SHAWN
Last Name:BURDICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 N KUAKINI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2488
Mailing Address - Country:US
Mailing Address - Phone:808-544-3362
Mailing Address - Fax:
Practice Address - Street 1:226 N KUAKINI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2488
Practice Address - Country:US
Practice Address - Phone:808-531-3511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI190882081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine