Provider Demographics
NPI:1659367936
Name:GROWNEY, DANIEL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOHN
Last Name:GROWNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2114 N LINCOLN AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:YORK
Mailing Address - State:NE
Mailing Address - Zip Code:68467-1072
Mailing Address - Country:US
Mailing Address - Phone:402-362-4339
Mailing Address - Fax:402-362-7743
Practice Address - Street 1:2114 N LINCOLN AVE
Practice Address - Street 2:SUITE B
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467-1028
Practice Address - Country:US
Practice Address - Phone:402-362-4339
Practice Address - Fax:402-362-7743
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI2855-320208600000X
NE19007208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100250143-00Medicaid
NEE49749Medicare UPIN
NE100250143-00Medicaid