Provider Demographics
NPI:1932461506
Name:MCDONALD, DANIELLE SUZANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:SUZANNE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 EDISEN ST.
Mailing Address - Street 2:
Mailing Address - City:BRUSH
Mailing Address - State:CO
Mailing Address - Zip Code:80723
Mailing Address - Country:US
Mailing Address - Phone:970-842-6262
Mailing Address - Fax:970-842-6241
Practice Address - Street 1:2400 EDISEN ST.
Practice Address - Street 2:
Practice Address - City:BRUSH
Practice Address - State:CO
Practice Address - Zip Code:80723
Practice Address - Country:US
Practice Address - Phone:970-842-6262
Practice Address - Fax:970-842-6241
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS9407845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine