Provider Demographics
NPI:1104817311
Name:DANIELS, GILBERT HARLAN (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:HARLAN
Last Name:DANIELS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:MASS GENERAL PHYSICIAN ORGANIZATION
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-8430
Mailing Address - Fax:617-726-5905
Practice Address - Street 1:15 PARKMAN ST
Practice Address - Street 2:THYROID ASSOCIATES WAC 730S
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-8430
Practice Address - Fax:617-726-5905
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA30109207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM08327OtherBCBS MA
MA700651OtherTUFTS HEALTH PLAN
MA2006863Medicaid
MAM08327Medicare PIN
MA700651OtherTUFTS HEALTH PLAN