Provider Demographics
NPI:1720075203
Name:HAGEMAN, DANIEL J (RDMS)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:HAGEMAN
Suffix:
Gender:M
Credentials:RDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10222 MONROVIA ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-1980
Mailing Address - Country:US
Mailing Address - Phone:913-599-4733
Mailing Address - Fax:913-599-4866
Practice Address - Street 1:10222 MONROVIA ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-1980
Practice Address - Country:US
Practice Address - Phone:913-599-4733
Practice Address - Fax:913-599-4866
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other