Provider Demographics
NPI:1639512809
Name:DANIELS, DAVID N (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:N
Last Name:DANIELS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:CB 8134
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-286-1700
Mailing Address - Fax:314-362-7017
Practice Address - Street 1:600 S TAYLOR AVE
Practice Address - Street 2:DEPT PSYCHIATRY, STE 122
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1035
Practice Address - Country:US
Practice Address - Phone:314-286-1700
Practice Address - Fax:314-362-7017
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2021-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20210114332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200094647Medicaid