Provider Demographics
NPI:1184734675
Name:MACIAS, DANIEL (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:MACIAS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 US ROUTE 60
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-8859
Mailing Address - Country:US
Mailing Address - Phone:304-528-4600
Mailing Address - Fax:
Practice Address - Street 1:3075 US ROUTE 60 STE A120
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25705-8859
Practice Address - Country:US
Practice Address - Phone:304-528-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16785207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0976449Medicaid
WV0077010000Medicaid
P00610562OtherMEDICARE RAILROAD
MI4636766Medicaid
OH0976449Medicaid
MI4636766Medicaid
WV4234741Medicare PIN