Provider Demographics
NPI:1386688091
Name:DANIELS, JASMIN C (MD)
Entity Type:Individual
Prefix:
First Name:JASMIN
Middle Name:C
Last Name:DANIELS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1831
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:901 JONES FRANKLIN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-3374
Practice Address - Country:US
Practice Address - Phone:919-852-5265
Practice Address - Fax:919-852-5267
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
NC2001001312084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89132N1Medicaid
NC89132N1Medicaid
NC2009067AMedicare PIN