Provider Demographics
NPI:1912124116
Name:ELWELL, DANIEL MARK (DO)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MARK
Last Name:ELWELL
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6901 MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7910
Mailing Address - Country:US
Mailing Address - Phone:254-751-4000
Mailing Address - Fax:361-356-1233
Practice Address - Street 1:6901 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7910
Practice Address - Country:US
Practice Address - Phone:254-751-4000
Practice Address - Fax:361-356-1233
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN6282207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine