Provider Demographics
NPI:1831504505
Name:OMIRE-MAYOR, DANIEL (DO, MS, MBA)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:OMIRE-MAYOR
Suffix:
Gender:M
Credentials:DO, MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 VARNUM ST NE FL HALL1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2107
Mailing Address - Country:US
Mailing Address - Phone:202-854-4812
Mailing Address - Fax:202-854-7825
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-854-4812
Practice Address - Fax:202-854-7825
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDO034694207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine