Provider Demographics
NPI:1922190552
Name:MEGLER, DANIEL DJ (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:DJ
Last Name:MEGLER
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 1:21000 E 12 MILE RD
Mailing Address - Street 2:STE 111
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081
Mailing Address - Country:US
Mailing Address - Phone:586-779-7610
Mailing Address - Fax:586-445-2523
Practice Address - Street 1:21000 E 12 MILE RD
Practice Address - Street 2:SUITE 111
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-1116
Practice Address - Country:US
Practice Address - Phone:586-779-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDM031809207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
102734OtherCARE CHOICES
B44170OtherHEALTH ALLIANCE PLAN
040008565OtherRAIL ROAD MEDICARE
108447OtherGREAT LAKES HEALTH
MI1313897Medicaid
4033125OtherAETNA
C4748OtherMCAR
MI040E061920OtherBLUE SHIELD GROUP
2438275001OtherCIGNA
0405032191OtherBLUE CROSS BLUE SHIELD
0503219OtherBLUE CARE NETWORK