Provider Demographics
NPI:1497876999
Name:DANIELS, KARREN REESE (OD)
Entity Type:Individual
Prefix:
First Name:KARREN
Middle Name:REESE
Last Name:DANIELS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15200 JENNINGS LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-7209
Mailing Address - Country:US
Mailing Address - Phone:301-390-7032
Mailing Address - Fax:
Practice Address - Street 1:48 WATKINS PARK DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1628
Practice Address - Country:US
Practice Address - Phone:301-249-5890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1045152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist