Provider Demographics
NPI:1831137819
Name:THAILER, DANIEL M (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:THAILER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 SHIRLEY TERRACE
Mailing Address - Street 2:
Mailing Address - City:KINNELON
Mailing Address - State:NJ
Mailing Address - Zip Code:07405
Mailing Address - Country:US
Mailing Address - Phone:973-493-2605
Mailing Address - Fax:
Practice Address - Street 1:2825 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-1018
Practice Address - Country:US
Practice Address - Phone:973-492-8402
Practice Address - Fax:828-327-4245
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-00405207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6879802Medicaid
NJF16699OtherHEALTHNET
NJP382632OtherOXFORD
NJP382632OtherOXFORD
NJ6879802Medicaid