Provider Demographics
NPI:1598254005
Name:BAX, DANIEL P (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:P
Last Name:BAX
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3041 ORCHARD PARK RD
Mailing Address - Street 2:STE C
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1238
Mailing Address - Country:US
Mailing Address - Phone:716-674-3104
Mailing Address - Fax:716-438-1430
Practice Address - Street 1:6000 BROCKTON DRIVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9273
Practice Address - Country:US
Practice Address - Phone:716-845-3400
Practice Address - Fax:716-438-1430
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2024-02-26
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Provider Licenses
StateLicense IDTaxonomies
NY323628207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology