Provider Demographics
NPI:1700468626
Name:SEGAR, DANIEL ALAN (PTA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:ALAN
Last Name:SEGAR
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PARK CENTER CT STE 102
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5613
Mailing Address - Country:US
Mailing Address - Phone:410-377-3484
Mailing Address - Fax:
Practice Address - Street 1:4 PARK CENTER CT STE 102
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5613
Practice Address - Country:US
Practice Address - Phone:410-377-3484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2059208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation