Provider Demographics
NPI:1689178881
Name:MARTIN, DANIEL (DO)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MARTIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 LOOMIS LN
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16423-1257
Mailing Address - Country:US
Mailing Address - Phone:814-881-4441
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST STE 200E
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-3550
Practice Address - Fax:412-647-7795
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0227172085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging