Provider Demographics
NPI:1790761575
Name:HESS, DANIEL M (DPM)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:HESS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 OLD FREDONIA RD
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:PA
Mailing Address - Zip Code:16137-4725
Mailing Address - Country:US
Mailing Address - Phone:724-662-7879
Mailing Address - Fax:724-662-1316
Practice Address - Street 1:2438 HUNTINGTON DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-2531
Practice Address - Country:US
Practice Address - Phone:724-662-7879
Practice Address - Fax:724-662-1316
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003589R213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013930470003Medicaid
PA672745Medicare ID - Type Unspecified
PAU17764Medicare UPIN