Provider Demographics
NPI:1942210216
Name:FALCON, DANIEL A (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:A
Last Name:FALCON
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 1:391 SERPENTINE DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3081
Mailing Address - Country:US
Mailing Address - Phone:864-585-4263
Mailing Address - Fax:864-585-9712
Practice Address - Street 1:391 SERPENTINE DR
Practice Address - Street 2:SUITE 440
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3081
Practice Address - Country:US
Practice Address - Phone:864-585-4263
Practice Address - Fax:864-585-9712
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC212492086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC90944OtherMEDCOST
SCCG6979OtherRAILROAD MEDICARE/GROUP
SC7620020OtherAETNA
SC0995050001OtherMEDICARE DMERC
SCGP1097Medicaid
SC0502545OtherCIGNA HMO
SC212497Medicaid
SCDM0789Medicaid
SC212497Medicaid