Provider Demographics
NPI:1275816951
Name:INBODEN, DANIEL W (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:INBODEN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47805-2920
Mailing Address - Country:US
Mailing Address - Phone:812-466-7536
Mailing Address - Fax:
Practice Address - Street 1:2040 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47805-2920
Practice Address - Country:US
Practice Address - Phone:812-466-7536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023122A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist