Provider Demographics
NPI:1770953648
Name:SEAVERS, DANIEL BERNARD (PHARMD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BERNARD
Last Name:SEAVERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6207 HALF DOME DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-1548
Mailing Address - Country:US
Mailing Address - Phone:704-965-3963
Mailing Address - Fax:
Practice Address - Street 1:5100 BEATTIES FORD RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28216-2357
Practice Address - Country:US
Practice Address - Phone:704-391-9341
Practice Address - Fax:704-399-9409
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist