Provider Demographics
NPI:1619913688
Name:READ, P DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:P
Middle Name:DANIEL
Last Name:READ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PETER
Other - Middle Name:DANIEL
Other - Last Name:READ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:112 HOSPITAL LN
Practice Address - Street 2:SUITE 100
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1977
Practice Address - Country:US
Practice Address - Phone:317-745-3740
Practice Address - Fax:317-745-3816
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01032836A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200007740Medicaid
IN354590UUUMedicare PIN
IN200007740Medicaid