Provider Demographics
NPI:1346275955
Name:SAPPENFIELD, DANIEL M (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:SAPPENFIELD
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 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10000 PARK CEDAR DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8902
Practice Address - Country:US
Practice Address - Phone:704-667-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC33465207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC080178684OtherMEDICARE RAILROAD
NC1346275955Medicaid
SCN33465Medicaid
NC7456BOtherNCBCBS
NC897456BMedicaid
NC7456BOtherNCBCBS
NC080178684OtherMEDICARE RAILROAD