Provider Demographics
NPI:1841246683
Name:MCDONALD, DANIEL S (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:S
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 955534
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-5534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:816 S KIRKWOOD RD STE 100
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6015
Practice Address - Country:US
Practice Address - Phone:314-686-4990
Practice Address - Fax:314-686-4999
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO102388207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOF54387Medicare UPIN
MO932250238Medicare ID - Type UnspecifiedSJHW-MO
MO000001609Medicare ID - Type UnspecifiedPRIVATE OFFICE
MO932250091Medicare ID - Type UnspecifiedSJH-MO