Provider Demographics
NPI:1104683945
Name:PAECH, DANIEL CHRISTIAN (MD, PHD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHRISTIAN
Last Name:PAECH
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BIGELOW ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-2307
Mailing Address - Country:US
Mailing Address - Phone:857-313-4439
Mailing Address - Fax:
Practice Address - Street 1:75 FRANCIS ST # L1-050
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-6106
Practice Address - Country:US
Practice Address - Phone:617-732-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program