Provider Demographics
NPI:1184605065
Name:DARTER, DANIELLE J (MD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:DARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:J
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:300 BOYD SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813-1401
Mailing Address - Country:US
Mailing Address - Phone:423-587-3407
Mailing Address - Fax:423-587-3405
Practice Address - Street 1:300 BOYD SCHOOL RD
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813-1401
Practice Address - Country:US
Practice Address - Phone:423-587-3407
Practice Address - Fax:423-587-3405
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2005-01165207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901605Medicaid
TNQ032035Medicaid
NC5901605Medicaid