Provider Demographics
NPI:1063699478
Name:BOYCE, DANIEL L (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:L
Last Name:BOYCE
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:PO BOX 337
Mailing Address - Street 2:908 SCARBRO ROAD
Mailing Address - City:SCARBRO
Mailing Address - State:WV
Mailing Address - Zip Code:25917-0337
Mailing Address - Country:US
Mailing Address - Phone:304-469-2905
Mailing Address - Fax:304-465-3180
Practice Address - Street 1:57 SUTPHIN LN
Practice Address - Street 2:
Practice Address - City:SCARBRO
Practice Address - State:WV
Practice Address - Zip Code:25917-8817
Practice Address - Country:US
Practice Address - Phone:304-469-4996
Practice Address - Fax:304-469-2981
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23944207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00907660OtherRAIL ROAD MEDICARE
WV3810018206Medicaid
WV2033712Medicare PIN
WV3810018206Medicaid
WVWV0107BMedicare PIN
WV2033713Medicare PIN
WVP00907660OtherRAIL ROAD MEDICARE