Provider Demographics
NPI:1477931954
Name:MCDANIEL, DARYA (OD)
Entity Type:Individual
Prefix:DR
First Name:DARYA
Middle Name:
Last Name:MCDANIEL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:DARYA
Other - Middle Name:
Other - Last Name:INOZEMTSEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 490
Mailing Address - Street 2:
Mailing Address - City:CHAMBERLAIN
Mailing Address - State:SD
Mailing Address - Zip Code:57325-0490
Mailing Address - Country:US
Mailing Address - Phone:605-734-5613
Mailing Address - Fax:605-734-4184
Practice Address - Street 1:103 E LAWLER AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325
Practice Address - Country:US
Practice Address - Phone:605-734-5613
Practice Address - Fax:605-734-4184
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006790152W00000X
SD767152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty