Provider Demographics
NPI:1356634497
Name:DANIELS, MICHAEL NEAL (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NEAL
Last Name:DANIELS
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 1:1255 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6256
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1255 S CEDAR CREST BLVD
Practice Address - Street 2:SUITE 3200
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6256
Practice Address - Country:US
Practice Address - Phone:610-402-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2014-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOT013926207R00000X, 207RN0300X
PAPAOT013926207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine