Provider Demographics
NPI:1205012275
Name:BRUMFIELD, DANIEL HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HOWARD
Last Name:BRUMFIELD
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:PO BOX 643197
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45264-3197
Mailing Address - Country:US
Mailing Address - Phone:513-863-6463
Mailing Address - Fax:513-863-2440
Practice Address - Street 1:3570 PLEASANT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45015-1747
Practice Address - Country:US
Practice Address - Phone:513-863-6463
Practice Address - Fax:513-863-2440
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-090980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000640100OtherANTHEM
OH0941182Medicaid
OH000000641595OtherANTHEM
OH4145223Medicare PIN
OH0941182Medicaid