Provider Demographics
NPI:1316017924
Name:MCKEE, DANIEL PAUL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:MCKEE
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 1:1420 LONDON ROAD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805
Mailing Address - Country:US
Mailing Address - Phone:218-724-3411
Mailing Address - Fax:218-724-3408
Practice Address - Street 1:1420 LONDON ROAD
Practice Address - Street 2:SUITE 202
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805
Practice Address - Country:US
Practice Address - Phone:218-724-3411
Practice Address - Fax:218-724-3408
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN31937207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN065T7MCOtherBLUECROSS AND BLUESHIELD
065T7MCOtherFIRST PLAN OF MINNESOTA
MN708202900Medicaid
HP22597OtherHEALTH PARTNERS
MN100015960OtherRAILROAD MEDICARE
WI31881100Medicaid
2900235OtherMEDICA
110283OtherUCARE
WI33826OtherLICENSE
MN708202900Medicaid
MN100000463Medicare PIN