Provider Demographics
NPI:1205875234
Name:POOLE, DANIEL THOMAS (MD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:THOMAS
Last Name:POOLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2609 MEDICAL OFFICE PL
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-9428
Mailing Address - Country:US
Mailing Address - Phone:919-734-1779
Mailing Address - Fax:919-734-7570
Practice Address - Street 1:2609 MEDICAL OFFICE PL
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-9428
Practice Address - Country:US
Practice Address - Phone:919-734-1779
Practice Address - Fax:919-734-7570
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2025-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC98010182084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG61472Medicare UPIN