Provider Demographics
NPI:1518900463
Name:SOHN, DANIEL G (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:G
Last Name:SOHN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:845 N NEW BALLAS CT
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7134
Practice Address - Country:US
Practice Address - Phone:314-983-4700
Practice Address - Fax:314-692-9862
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2019-07-19
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Provider Licenses
StateLicense IDTaxonomies
MOR9F78208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200044074OtherRAILROAD MEDICARE
MO99752V3223OtherGROUP HEALTH PLAN
MO13776OtherBLUE CROSS BLUE SHIELD
MO5506753003OtherCIGNA
MO118747OtherHEALTHLINK
MO2300179OtherUNITED HEALTHCARE
MO4452646OtherAETNA
MO202654414Medicaid
MO5506753003OtherCIGNA
MO202654414Medicaid