Provider Demographics
NPI:1861485906
Name:WILL, DANIEL V (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:V
Last Name:WILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 N YORK RD
Mailing Address - Street 2:
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-2045
Mailing Address - Country:US
Mailing Address - Phone:215-672-9030
Mailing Address - Fax:215-672-8099
Practice Address - Street 1:345 N YORK RD
Practice Address - Street 2:
Practice Address - City:HATBORO
Practice Address - State:PA
Practice Address - Zip Code:19040-2045
Practice Address - Country:US
Practice Address - Phone:215-672-9030
Practice Address - Fax:215-672-8099
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424504207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA080760Medicare ID - Type Unspecified
PAH56490Medicare UPIN