Provider Demographics
NPI:1255421020
Name:IRIS B DANIEL MD PC
Entity type:Organization
Organization Name:IRIS B DANIEL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:IRIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD PC
Authorized Official - Phone:586-263-7900
Mailing Address - Street 1:42490 GARFIELD
Mailing Address - Street 2:SUITE 207 HYPERBARIC MEDICAL CENTER
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038
Mailing Address - Country:US
Mailing Address - Phone:586-263-7900
Mailing Address - Fax:586-263-0434
Practice Address - Street 1:42490 GARFIELD
Practice Address - Street 2:SUITE 207 HYPERBARIC MEDICAL CENTER
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038
Practice Address - Country:US
Practice Address - Phone:586-263-7900
Practice Address - Fax:586-263-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty