Provider Demographics
NPI:1942217237
Name:CHASE, DANIEL W (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:CHASE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 MAIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:TOPSHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04086-1240
Mailing Address - Country:US
Mailing Address - Phone:207-729-1689
Mailing Address - Fax:207-798-3930
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:TOPSHAM
Practice Address - State:ME
Practice Address - Zip Code:04086-1240
Practice Address - Country:US
Practice Address - Phone:207-729-1689
Practice Address - Fax:207-798-3930
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME014461207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM678604Medicare PIN
MEG47150Medicare UPIN
MEMM6786Medicare ID - Type UnspecifiedMEDICARE
MEMM678603Medicare PIN