Provider Demographics
NPI:1225032873
Name:MATEER, DANIEL T (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:T
Last Name:MATEER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:51 BUSINESS CAMPUS WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:DUNCANNON
Practice Address - State:PA
Practice Address - Zip Code:17020-9596
Practice Address - Country:US
Practice Address - Phone:717-834-3108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008853L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001559977Medicaid
PAG20426Medicare UPIN
PA239100NZRMedicare PIN