Provider Demographics
NPI:1295710192
Name:ALBRIGHT, DANIEL A (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A
Last Name:ALBRIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S PO BOX 1309
Mailing Address - Street 2:MS 21110Q
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13688 ROGERS DR STE 230
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4918
Practice Address - Country:US
Practice Address - Phone:952-977-0300
Practice Address - Fax:952-977-0311
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN38594208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN639722100Medicaid
MN110006008Medicare ID - Type Unspecified
MN639722100Medicaid