Provider Demographics
NPI:1104265479
Name:LINDBERG, DANIELLE KRISTINE (DO)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:KRISTINE
Last Name:LINDBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:KRISTINE
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:5800 LANDERBROOK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4083
Mailing Address - Country:US
Mailing Address - Phone:216-273-9800
Mailing Address - Fax:216-273-9998
Practice Address - Street 1:5800 LANDERBROOK DR STE 220
Practice Address - Street 2:
Practice Address - City:MAYFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44124-4083
Practice Address - Country:US
Practice Address - Phone:216-273-9800
Practice Address - Fax:216-273-9998
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014784207Q00000X
MO2016022725207Q00000X
KS05-41637207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOPENDINGMedicaid
MOPENDINGMedicare PIN