Provider Demographics
NPI:1558334847
Name:MESHOTO, DANIEL JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:MESHOTO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:11110 LINDBERGH BUSINESS COURT
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-7810
Mailing Address - Country:US
Mailing Address - Phone:314-845-8888
Mailing Address - Fax:314-845-8833
Practice Address - Street 1:11110 LINDBERGH BUSINESS COURT
Practice Address - Street 2:
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7810
Practice Address - Country:US
Practice Address - Phone:314-845-8888
Practice Address - Fax:314-845-8833
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2010-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MODO104006207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOG27101Medicare UPIN