Provider Demographics
NPI:1588603252
Name:LE, DANIEL D (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:D
Last Name:LE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:484 HIGHLAND AVE
Mailing Address - Street 2:RADIOLOGY DEPARTMENT
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-3704
Mailing Address - Country:US
Mailing Address - Phone:508-677-9729
Mailing Address - Fax:508-679-4728
Practice Address - Street 1:363 HIGHLAND AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3703
Practice Address - Country:US
Practice Address - Phone:508-677-9729
Practice Address - Fax:508-679-4728
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-04-09
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Provider Licenses
StateLicense IDTaxonomies
GUM-22132085R0202X
MA1586482085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3205053Medicaid
RI7006604Medicaid
G22852Medicare UPIN
RI7006604Medicaid