Provider Demographics
NPI:1275875908
Name:MARION, DANIEL MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MICHAEL
Last Name:MARION
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:121 SAINT LUKES CENTER DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3518
Mailing Address - Country:US
Mailing Address - Phone:314-205-6160
Mailing Address - Fax:
Practice Address - Street 1:121 SAINT LUKES CENTER DR
Practice Address - Street 2:SUITE 402
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3518
Practice Address - Country:US
Practice Address - Phone:314-205-6160
Practice Address - Fax:314-590-5198
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2016-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2016018222207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO147320002Medicare UPIN