Provider Demographics
NPI:1457525206
Name:EVERITT, DANIEL ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ERIC
Last Name:EVERITT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1061 WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2234
Mailing Address - Country:US
Mailing Address - Phone:484-919-0017
Mailing Address - Fax:609-730-4326
Practice Address - Street 1:1061 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-2234
Practice Address - Country:US
Practice Address - Phone:484-919-0017
Practice Address - Fax:609-730-4326
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD043748L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine