Provider Demographics
NPI:1518181148
Name:BOXWELL, DANIEL FREDERICK (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:FREDERICK
Last Name:BOXWELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 STORK WAY
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-1039
Mailing Address - Country:US
Mailing Address - Phone:248-310-3473
Mailing Address - Fax:
Practice Address - Street 1:215 STORK WAY
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-1039
Practice Address - Country:US
Practice Address - Phone:248-310-3473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1521207YS0123X
OH34009892207YS0123X
MI5101016633207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH06902OtherPARAMOUNT
OH000000668902OtherANTHEM
SC015218Medicaid
OH62083OtherHPM
SCGP4697Medicaid
OHP00896658OtherRRMC
OH3067087Medicaid
OH9806580OtherAETNA
OH9806580OtherAETNA
OH3067087Medicaid