Provider Demographics
NPI:1720124001
Name:CASE, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:CASE
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 1:701 E 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2412
Mailing Address - Country:US
Mailing Address - Phone:518-322-6495
Mailing Address - Fax:509-534-1071
Practice Address - Street 1:701 E 10TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2412
Practice Address - Country:US
Practice Address - Phone:518-322-6495
Practice Address - Fax:509-534-1071
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170438207P00000X
GUM-1809207P00000X
WA00028745208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00430222Medicaid
NYE83693Medicare UPIN
GUH109127Medicare Oscar/Certification
NYG400045385Medicare PIN