Provider Demographics
NPI:1700876018
Name:MAISON, DANIEL LEON (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:LEON
Last Name:MAISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6400 SHAFER CT STE 700
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4989
Mailing Address - Country:US
Mailing Address - Phone:346-376-1702
Mailing Address - Fax:
Practice Address - Street 1:5457 TWIN KNOLLS RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3263
Practice Address - Country:US
Practice Address - Phone:410-689-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097415207R00000X
FLME84214207R00000X
CAA62106207R00000X
MDD84710207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH01714Medicare UPIN
CAA62106OtherCALIFORNIA MEDICAL LICENS
FLME84214OtherFLORIDA MEDICAL LICENSE