Provider Demographics
NPI:1881045631
Name:NADEAU, DANIEL ROBERT (DO, MHSA)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:NADEAU
Suffix:
Gender:M
Credentials:DO, MHSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 GIBNER RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE BARRACKS
Mailing Address - State:PA
Mailing Address - Zip Code:17013-5090
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:450 GIBNER RD
Practice Address - Street 2:
Practice Address - City:CARLISLE BARRACKS
Practice Address - State:PA
Practice Address - Zip Code:17013-5090
Practice Address - Country:US
Practice Address - Phone:717-701-1451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-23
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102204972207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine