Provider Demographics
NPI:1437128337
Name:PICARD, DANIEL LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LOUIS
Last Name:PICARD
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 1:9000 FRANKLIN SQUARE DRIVE
Mailing Address - Street 2:ADMIN 2 WEST
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3901
Mailing Address - Country:US
Mailing Address - Phone:443-777-7123
Mailing Address - Fax:
Practice Address - Street 1:9000 FRANKLIN SQUARE DRIVE
Practice Address - Street 2:ADMIN 2 WEST
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-7123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045507208600000X
MDD45507208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B17054Medicare UPIN
MDH454JY83Medicare PIN
MDB17054Medicare UPIN