Provider Demographics
NPI:1376804203
Name:EADS, DANIEL SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:SCOTT
Last Name:EADS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1830 S ALMA SCHOOL RD
Mailing Address - Street 2:STE 108
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3086
Mailing Address - Country:US
Mailing Address - Phone:480-248-3070
Mailing Address - Fax:480-248-3050
Practice Address - Street 1:1830 S ALMA SCHOOL RD STE 108
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3086
Practice Address - Country:US
Practice Address - Phone:480-248-3000
Practice Address - Fax:480-248-3050
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCLL34744208G00000X
AZ55508208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty