Provider Demographics
NPI:1740465509
Name:MARECK, DANIEL GERARD (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:GERARD
Last Name:MARECK
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:BUREAU OF HEALTH PROF/HRSA 5600 FISHERS LANE RM 8-05
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20857-0001
Mailing Address - Country:US
Mailing Address - Phone:301-594-4198
Mailing Address - Fax:301-443-2111
Practice Address - Street 1:BUREAU OF HEALTH PROF/HRSA 5600 FISHERS LANE RM 8-05
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20857-0001
Practice Address - Country:US
Practice Address - Phone:301-594-4198
Practice Address - Fax:301-443-2111
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-29
Last Update Date:2007-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine