Provider Demographics
NPI:1407965544
Name:WESTER, DANIEL COOPER (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:COOPER
Last Name:WESTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:COOPER
Other - Middle Name:
Other - Last Name:WESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:229 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ST MARIES
Mailing Address - State:ID
Mailing Address - Zip Code:83861-1803
Mailing Address - Country:US
Mailing Address - Phone:208-245-5551
Mailing Address - Fax:208-245-9303
Practice Address - Street 1:229 S 7TH ST
Practice Address - Street 2:
Practice Address - City:ST MARIES
Practice Address - State:ID
Practice Address - Zip Code:83861-1803
Practice Address - Country:US
Practice Address - Phone:208-245-5111
Practice Address - Fax:208-245-9303
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-6975207Q00000X, 208M00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1407965544Medicaid
WA1091680Medicaid